A clinical study of immediate cardioversion of atrial fibrillation and atrial flutter attacking less than 90 days with ibutilide versus propafenone

Objective:To assess the efficacy and safety of ibutilide versus propafenone in imme- diate eardioversion of atrial fibrillation (AF) and atrial flutter (AFL) attacking less than 90 days.Meth- ods:A prospective,randomized single blind and comparison controlled clinical study recruited 40 pa- tients who were attacked AF or AFL less than 90 days.The patients were randomized to one of two treat- ment groups:ibutilide (1 mg,iv,n=22) and propafenone (70 mg,iv,n=18).The study drugs were infused within 10 minutes in aids of ECG and blood pressure monitoring.The patients who remained AF/AFL at the end of 10-minute infusion were repeated the infusion procedure of study drugs.The con- version rate within 1.5 hours and adverse effects within 4 hours were recorded.Results:The ibutilide- treated patients had the AF/AFL conversion rate of 63.6%,compared with the propafenone-treated pa- tients of 27.8 % (P＜0.05).The patients in ibutilide group experienced an incidence rate of transitory ventricular tachycardia of 4.4% and ventricular premature heat of 8.1%,which disappeared without any treatment.Conclusion:Intravenous administration of ibutilide in eardioversion of AF and AFL is safe and effective.