Abstract

The purpose of this study was to assess the efficacy and safety of ibutilide, a class III antiarrhythmic drug, for acute treatment of atrial fibrillation (AF) in the emergency department (ED) setting. A retrospective analysis was done reviewing all patients with AF who received ibutilide in the ED in a university hospital setting. A total of 22 patients received ibutilide. Another 24 patients who received rate control drugs only served as a control group. Of the 22 patients who received ibutilide, 14 (64%) converted to sinus rhythm. The mean (SD) rate of AF was 137 (24) bpm and the mean QT_c interval immediately after conversion to sinus rhythm was 420 (28) ms. There were no complications. In the rate control group 7 patients (29%) converted to sinus rhythm (p<0.05, compared with ibutilide). The mean rate of AF was 126 (26) bpm (p = ns, compared with ibutilide) and the mean QT_c interval in those who converted was 377 (28) ms (p<0.05, compared with ibutilide). One patient developed severe bradycardia. Ibutilide is effective for conversion of recent onset AF in patients presenting to the ED and there is a low rate of complications from ibutilide in this setting.