Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Acute management of atrial fibrillation and atrial flutter in the criticalcare unit: Should it be ibutilide?
Autore:
Varriale, P; Sedighi, A;
Indirizzi:
Cabrini Med Ctr New York, Dept Cardiol, New York, NY USA Cabrini Med Ctr New York New York NY USA Dept Cardiol, New York, NY USA
Titolo Testata:
CLINICAL CARDIOLOGY
fascicolo: 4, volume: 23, anno: 2000,
pagine: 265 - 268
SICI:
0160-9289(200004)23:4<265:AMOAFA>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAVENOUS IBUTILIDE; AMIODARONE; EFFICACY; HEART; PROPAFENONE; DYSFUNCTION; DISPERSION; CONVERSION; SAFETY; AGENT;
Keywords:
atrial fibrillation; ibutilide; cardioversion; antiarrhythmic drugs;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Varriale, P 222 East 19th St, New York, NY 10021 USA 222 East 19th St NewYork NY USA 10021 New York, NY 10021 USA
Citazione:
P. Varriale e A. Sedighi, "Acute management of atrial fibrillation and atrial flutter in the criticalcare unit: Should it be ibutilide?", CLIN CARD, 23(4), 2000, pp. 265-268

Abstract

Background: Ibutilide is currently indicated for the rapid conversion of atrial fibrillation (Afb) or atrial flutter (Afl) of recent onset but limited to patients who are hemodynamically stable and without symptomatic cardiovascular conditions. Hypothesis: The study was undertaken to assess the efficacy and safety of ibutilide in patients with Afb or Afl associated with acute cardiovascular-medical disorders and in patients receiving prior selective antiarrhythmic drug therapy. Methods: The study included 34 patients, mean age 75 +/- 16.3 years, with Afb (n = 25) or Afl (n = 9) having a variety of disorders, for example, congestive heart failure, unstable angina, borderline hypotension, respiratoryfailure, and chronic renal failure. Prior antiarrhythmic drugs consisted of propafenone (n = 5) or amiodarone (n = 3). Eligibility for cardioversion was established with appropriate anticoagulation or transesophageal echocardiography findings. Ibutilide was given as up to two 10 min infusions of 1 mg separated by 10 min. Results: The overall conversion rate after ibutilide was 79.4% (27/34 patients): 80% for Afb and 78% for Afl. More than 90% converted within 1 h of treatment. A high conversion rate of 92% resulted in those with an arrhythmia duration of less than or equal to 1 week. All eight patients with prior antiarrhythmic therapy converted to sinus rhythm. The average baseline QTc interval for all patients increased 17.1% (397 +/- 63.3 to 465 +/- 60.2 ms) at 30 min. For eight patients (including four who received prior antiarrhythmic drugs), QTc interval prolongation greater than or equal to 500 ms was associated with nearly half the entire incidence of arrhythmic events. Proarrhythmia, the exclusive adverse effect, consisted of ventricular extrasystoles (n = 10) and nonsustained monomorphic ventricular tachycardia (VT) (n = 2) managed with intravenous MgSO4, and sustained polymorphic VT (n = 1) requiring electrical cardioversion. Conclusion: Ibutilide is an effective and well tolerated drug for the rapid termination of Afb or Afl of recent onset associated with symptomatic and/or hemodynamically unstable disorders, and it is most efficacious (greaterthan or equal to 90%) when the atrial arrhythmia is less than or equal to 1 week in duration. Proarrhythmic events are readily manageable in a monitored unit with access to appropriate treatment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 21:51:20