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Titolo:
Chemical cardioversion of atrial fibrillation or flutter with ibutilide inpatients receiving amiodarone therapy
Autore:
Glatter, K; Yang, YF; Chatterjee, K; Modin, G; Cheng, J; Kayser, S; Scheinman, MM;
Indirizzi:
Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USAUniv Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Sect Cardiac Electrophysiol, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA SUNY Syracuse, Sect Cardiac Electrophysiol, Syracuse, NY 13210 USA SUNY Syracuse Syracuse NY USA 13210 lectrophysiol, Syracuse, NY 13210 USA
Titolo Testata:
CIRCULATION
fascicolo: 2, volume: 103, anno: 2001,
pagine: 253 - 257
SICI:
0009-7322(20010116)103:2<253:CCOAFO>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
TORSADE-DE-POINTES; INTRAVENOUS IBUTILIDE; CARDIAC-ARRHYTHMIAS; CONVERSION EFFICACY; QT DISPERSION; M-CELLS; I-KR; SAFETY; AFTERDEPOLARIZATIONS; PROCAINAMIDE;
Keywords:
ibutilide; amiodarone; torsade de pointes; cardioversion; atrial flutter; fibrillation; arrhythmia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Scheinman, MM Univ Calif San Francisco, Cardiovasc Res Inst, 500 ParnassusAve,MU E 4S Box 1354, San Francisco, CA 94143 USA Univ Calif San Francisco500 Parnassus Ave,MU E 4S Box 1354 San Francisco CA USA 94143
Citazione:
K. Glatter et al., "Chemical cardioversion of atrial fibrillation or flutter with ibutilide inpatients receiving amiodarone therapy", CIRCULATION, 103(2), 2001, pp. 253-257

Abstract

Backgrould-Ibutilide is a class III drug that is used for the cardioversion of atrial arrhythmias, but it can cause torsade de pointes. Amiodarone also prolongs the QT interval but rarely causes torsade de pointes. There areno studies in which the concomitant use of the 2 agents was examined. The purpose of the present study was to assess the efficacy and safety of cardioversion with combination therapy in patients with atrial fibrillation or flutter. Methods ann Results-The study included 70 patients who were treated with long-term oral amiodarone and were referred for elective cardioversion of atrial fibrillation (57 of 70, 81%) or flutter (13 of 70, 19%). Patients weretaking amiodarone (153+/-259 days, mean+/-SD) and were administered 2 mg intravenous ibutilide. Left ventricular ejection fraction was measured with echocardiography. The QT intervals were measured on 12-lead EGG. Fifty-fivepatients (79%) had structural heart disease. Patients were in arrhythmia for 196+/-508 days before cardioversion, with a left ventricular ejection fraction of 50+/-11%. In patients with atrial fibrillation, 22 (39%) of 57 and 7 (54%) of 13 patients with flutter converted within 30 minutes of infusion. Thirty-nine patients who did not convert after ibutilide were treated with electrical cardioversion, and 35 (90%) of 39 patients were successfullyconverted. The QT intervals were further prolonged after ibutilide for thegroup from 371+/-61 to 479+/-92 ms (P<0.001). There was 1 episode of nonsustained torsade de pointes (I of 70, 1.4%) after ibutilide. Conclusions-The use of ibutilide converted 54% of patients with atrial flutter and 39% Of patients with atrial fibrillation who were treated with long-term amiodarone, Despite QT-interval prolongation after ibutilide, only 1episode of torsade de pointes occurred. Our observations suggest that combination therapy may be a useful cardioversion method for chronic atrial fibrillation or flutter.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 21:02:59