The Efficacy and Characteristics of Intraprocedural Use of Ibutilide during Stepwise Linear Catheter Ablation of Persistent Atrial Fibrillation

Objective: Ibutilide is commonly used for acute conversion of atrial fibrillation (AF) and flutter. The purpose of this study was to determine the efficacy and safety of ibutilide for the rapid conversion of persistent AF during the procedure of radiofrequency catheter ablation (RFCA).Methods: Ibutilide was administered intravenously to 58 consecutive persistent AF patients which failed to restore sinus rhythm (SR) after extensive linear RFCA. The mean duration of AF was 15.5±18.9 months. Blood pressure and corrected QT (QTc) interval were continuous monitored.Results: There were 46 (79.3%) patients converted to sinus rhythm (SR) by infusion of Ibutilide after RFCA with mean conversion times of 12.5±9.9 min. The mean dosage was 1.06±0.33 mg. 28 (48.3%) patients experienced left atrial flutter (LAFL) before restoration of SR. There was a statistically significant prolongation in QTc interval after 5 minutes of infusion (from 452.5 ms to 506.4 ms, P<0.001). No patient experienced sustained ventricular arrhythmias or torsades de pointe. During a median follow up of 32 months, 62.1% of patients were free from AF or LAFL.Conclusion: Ibutilide is safe and effective in sinus rhythm restoration in the procedure of persistent atrial fibrillation catheter ablation.