Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .
Efficacy and safety of ibutilide fumarate for the conversion of atrial arrhythmias after cardiac surgery.
BACKGROUND Atrial arrhythmias occur commonly after cardiac surgery and are a cause of significant morbidity and increased hospital costs , yet there is no well-studied treatment strategy to deal with them expeditiously . The purpose of this study was to determine the efficacy and safety of ibutilide fumarate , an approved drug for the rapid conversion of atrial fibrillation and flutter , in patients after cardiac surgery . METHODS AND RESULTS Patients with atrial fibrillation or flutter occurring 1 to 7 days after surgery and lasting 1 hour to 3 days were r and omized to receive two 10-minute blinded infusions of placebo or 0.25 , 0.5 , or 1.0 mg of ibutilide fumarate . Treatment was considered successful if sinus rhythm was restored for any period of time by hour 1.5 . A total of 302 patients were r and omized , 201 with fibrillation and 101 with flutter . Treatment with ibutilide result ed in significantly higher conversion rates than placebo , and efficacy was dose related ( placebo 15 % ; ibutilide 0.25 mg 40 % , 0.5 mg 47 % , and 1.0 mg 57 % ) . Conversion rates at all doses were higher for atrial flutter than for atrial fibrillation . Mean time to conversion decreased as the dose was increased . Polymorphic ventricular tachycardia was the most serious adverse effect and occurred in 1.8 % of the ibutilide-treated patients compared with 1.2 % of patients who received placebo . CONCLUSIONS Ibutilide is a useful and safe treatment alternative for the atrial arrhythmias that occur after cardiac surgery
Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .