Efficacy of Ibutilide for Terminating Recent Onset Atrial Fibrillation- A Single Centre Study

Introduction: Ibutilide is a class 3 antiarrythmic agent that is used infrequently. There are few studies on its usage, especially among Indians. Materials & Methods: A retrospective study was conducted on patients in a tertiary care unit who had recently developed atrial fibrillation and were given the normal dose of ibutilide. During the study period, data was gathered from medical records. Results: During the study period, ibutilide was given to a total of 40 patients who met the inclusion criteria. The majority of the participants were under 60 years old and had only been in atrial fibrillation for less than 24 hours. In 70% of cases, atrial fibrillation could be successfully terminated with only a small risk of adverse events. Conclusion: Ibutilide is a safe and effective treatment for people who have recent onset atrial fibrillation.

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Intravenous vernakalant in comparison with intravenous flecainide in the cardioversion of recent-onset atrial fibrillation

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872617728558 ◽

2017 ◽

Vol 8 (2) ◽

pp. 114-120 ◽

Cited By ~ 9

Author(s):

Hanna Pohjantähti-Maaroos ◽

Harri Hyppölä ◽

Maria Lekkala ◽

Emma Sinisalo ◽

Antti Heikkola ◽

...

Keyword(s):

Atrial Fibrillation ◽

Confidence Interval ◽

Odds Ratio ◽

Female Gender ◽

Efficacy And Safety ◽

Single Centre ◽

Recent Onset ◽

The Difference ◽

Pharmacological Cardioversion ◽

Onset Atrial Fibrillation

Background: Pharmacological cardioversion of atrial fibrillation is a reasonable alternative for electrical cardioversion in acute atrial fibrillation. We compared the efficacy and safety of intravenous vernakalant and intravenous flecainide in patients with recent-onset (< 48 h) atrial fibrillation. Methods: A total of 200 consecutive patients, 100 patients undergoing cardioversion with intravenous vernakalant and 100 patients undergoing cardioversion with intravenous flecainide, were included in this single centre non-randomized retrospective study. The primary endpoint was conversion to sinus rhythm within 120 minutes from the drug administration. Results: Cardioversion was successful in 67% of patients treated with vernakalant and in 46% of patients treated with flecainide ( p=0.003). Vernakalant (odds ratio 1.99, 95% confidence interval 1.08–3.69, p=0.029) and female gender (odds ratio 2.48, 95% confidence interval 1.22–15.05, p=0.012) were significant predictors of successful cardioversion. The success rate of cardioversion was lowest among men treated with flecainide (36.9%). Patients treated with vernakalant were discharged earlier from the emergency department compared with those treated with flecainide (8.2 ± 4.7 h vs. 12.0 ± 6.0 h, p < 0.001). There was no difference in the complication rate between the groups. Vernakalant treated patients were older (59.3 ± 12.5 vs. 55.4 ± 13.0 years, p=0.03), had higher CHA2DS2-VASc score (1.4 ± 1.3 vs. 0.9 ± 1.2, p = 0.002) and were more often on beta-blocker medication (59% vs. 42%, p= 0.016) than flecainide treated patients. Conclusion: Vernakalant was safe, more effective and faster than flecainide in the cardioversion of recent-onset atrial fibrillation. The difference in efficacy was especially apparent among men.

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Abstract 15296: Vernakalant Shows Superiority to Ibutilide in Recent-onset Atrial Fibrillation: A Randomized Controlled Trial at the Emergency Department

Circulation ◽

10.1161/circ.132.suppl_3.15296 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Alexander Simon ◽

Jan Niederdöckl ◽

Ekaterini Skyllouriotis ◽

Nikola Schütz ◽

Christoph Weiser ◽

...

Keyword(s):

Atrial Fibrillation ◽

Emergency Department ◽

Adverse Events ◽

Sinus Rhythm ◽

Tertiary Care ◽

Care Hospital ◽

Recent Onset ◽

Randomized Controlled ◽

Conversion Rates ◽

Onset Atrial Fibrillation

Introduction: Ibutilide is a rapid-acting antiarrhythmic drug with worldwide use for conversion of recent-onset atrial fibrillation. Vernakalant is a novel drug, which is likewise used intravenously, with proven effectiveness and safety compared to placebo and amiodarone in randomized clinical trials. Hypothesis: We hypothesized that the time to sinus rhythm and the conversion rate within 90 minutes is different between vernakalant and ibutilide in patients with recent-onset atrial fibrillation. Methods: A randomized, controlled, open-label trial registered at clinicaltrials.gov (NCT01447862) was performed in one hundred patients with recent-onset atrial fibrillation treated at the emergency department of a tertiary care hospital. Patients received up to two short-infusions of vernakalant (n= 49; 3mg/kg, 2mg/kg) or ibutilide (n= 51; 1mg, 1mg) according to the manufacturer’s instructions. Clinical and laboratory variables, adverse events, conversion rates and time to conversion were recorded. Results: Time to conversion of AF to sinus rhythm was significantly shorter in the vernakalant group compared to the ibutilide group (median time: 10min vs. 26min, p=0.02), and likewise the conversion success within 90 minutes was significantly higher (69% vs. 43%, p=0.01) in the vernakalant group. In both groups no serious adverse events occurred. Conclusion: Vernakalant was significantly faster and more effective in converting recent-onset atrial fibrillation to sinus rhythm at the emergency department.

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