INTRODUCTION: Atrial flutter is a common sustained atrial tachyarrhythmia for which frequency increases with age. Ibutilide is a novel class III antiarrhythmic agent used for the rapid cardioversion of atrial fibrillation or atrial flutter. AIM: The aim of our study was to assess the use of ibutilide in a selected population of very elderly patients (octogenarians) with recent-onset atrial flutter. METHOD: Twenty-nine consecutive elderly patients (11 male, 18 female; mean age 83 +/- 3 years; interquartile range of 10) with recent-onset atrial flutter were included in the study; none of them had signs or symptoms of severe heart failure, angina or impaired renal or hepatic function. All patients underwent a 10-minute intravenous infusion of ibutilide (0.87 mg in 10 ml). RESULTS: The rate of successful arrhythmia termination was 75.9% within a mean time of 31 +/- 20 minutes. No clinical variables were shown to be associated with successful cardioversion, although there was a tendency towards higher efficacy in patients with a shorter duration of arrhythmia. Two female patients (6.9%) developed torsade de pointes, requiring direct current cardioversion under general anaesthesia. Episodes of nonsustained ventricular tachycardia occurred in two other patients. CONCLUSION: Ibutilide appears to be an effective and well tolerated drug for rapid conversion of recent-onset atrial flutter in octogenarian patients, and may represent a valid approach in the acute management of atrial flutter in this particular set of patients.
INTRODUCTION:Atrial flutter is a common sustained atrial tachyarrhythmia for which frequency increases with age. Ibutilide is a novel class III antiarrhythmic agent used for the rapid cardioversion of atrial fibrillation or atrial flutter. AIM: The aim of our study was to assess the use of ibutilide in a selected population of very elderly patients (octogenarians) with recent-onset atrial flutter. METHOD: Twenty-nine consecutive elderly patients (11 male, 18 female; mean age 83 +/- 3 years; interquartile range of 10) with recent-onset atrial flutter were included in the study; none of them had signs or symptoms of severe heart failure, angina or impaired renal or hepatic function. All patients underwent a 10-minute intravenous infusion of ibutilide (0.87 mg in 10 ml). RESULTS: The rate of successful arrhythmia termination was 75.9% within a mean time of 31 +/- 20 minutes. No clinical variables were shown to be associated with successful cardioversion, although there was a tendency towards higher efficacy in patients with a shorter duration of arrhythmia. Two female patients (6.9%) developed torsade de pointes, requiring direct current cardioversion under general anaesthesia. Episodes of nonsustained ventricular tachycardia occurred in two other patients. CONCLUSION:Ibutilide appears to be an effective and well tolerated drug for rapid conversion of recent-onset atrial flutter in octogenarian patients, and may represent a valid approach in the acute management of atrial flutter in this particular set of patients.
Authors: S G Priori; E Aliot; C Blomstrom-Lundqvist; L Bossaert; G Breithardt; P Brugada; A J Camm; R Cappato; S M Cobbe; C Di Mario; B J Maron; W J McKenna; A K Pedersen; U Ravens; P J Schwartz; M Trusz-Gluza; P Vardas; H J Wellens; D P Zipes Journal: Eur Heart J Date: 2001-08 Impact factor: 29.983
Authors: H Nakagawa; R Lazzara; T Khastgir; K J Beckman; J H McClelland; S Imai; J V Pitha; A E Becker; M Arruda; M D Gonzalez; L E Widman; M Rome; J Neuhauser; X Wang; J D Calame; M D Goudeau; W M Jackman Journal: Circulation Date: 1996-08-01 Impact factor: 29.690
Authors: J Granada; W Uribe; P H Chyou; K Maassen; R Vierkant; P N Smith; J Hayes; E Eaker; H Vidaillet Journal: J Am Coll Cardiol Date: 2000-12 Impact factor: 24.094