87085
document
Comparative efficacy of intravenous ibutilide versus procainamide for enhancing termination of atrial flutter by atrial overdrive pacing . This study compares the influence of intravenous ibutilide , a class III antiarrhythmic agent , with procainamide , a class IA antiarrhythmic agent , and with placebo on its ability to terminate atrial flutter using rapid atrial pacing . Fifty-nine episodes of atrial flutter in 54 patients who failed to terminate with an intravenous infusion of ibutilide , procainamide , or placebo alone underwent attempts at pacing termination using a standard protocol of burst atrial overdrive pacing . Atrial flutter cycle length and atrial monophasic action potential duration recorded from the right atrium during atrial flutter were measured at baseline and following infusion of ibutilide , procainamide , or placebo . Both ibutilide and procainamide significantly enhanced ( p < 0.001 ) pacing-induced termination of atrial flutter compared with placebo . Pacing converted 2 of 11 patients ( 18 % ) who received placebo , 13 of 15 patients ( 87 % ) who received ibutilide , and 29 of 33 patients ( 88 % ) who received procainamide to sinus rhythm . Ibutilide and procainamide compared with placebo markedly reduced ( p < 0.001 ) the incidence of pacing-induced atrial fibrillation . The atrial flutter cycle length was prolonged significantly less ( p < 0.001 ) , and the atrial monophasic action potential duration was increased significantly more ( p < 0.001 ) by ibutilide than by procainamide . Although the electrophysiologic changes induced by these antiarrhythmic agents contributed to facilitating pacing-induced termination , neither tachycardia cycle length nor action potential duration were useful predictors of the ability of pacing to terminate atrial flutter . In conclusion , despite differing electrophysiologic effects , the use of intravenous ibutilide or procainamide enhances the termination of atrial flutter by atrial overdrive pacing .
87086
Intervention_Pharmacological
ibutilide
87087
Intervention_Pharmacological
procainamide
87088
Intervention_Pharmacological
ibutilide
87089
Intervention_Pharmacological
procainamide
87090
Intervention_Control
placebo
87091
Intervention_Pharmacological
ibutilide
87092
Intervention_Pharmacological
procainamide
87093
Intervention_Control
placebo
87094
Intervention_Pharmacological
ibutilide
87095
Intervention_Pharmacological
procainamide
87096
Intervention_Control
placebo .
87097
Intervention_Pharmacological
ibutilide
87098
Intervention_Pharmacological
procainamide
87099
Intervention_Control
placebo .
87100
Intervention_Control
placebo
87101
Intervention_Pharmacological
ibutilide
87102
Intervention_Pharmacological
procainamide
87103
Intervention_Pharmacological
Ibutilide
87104
Intervention_Pharmacological
procainamide
87105
Intervention_Control
placebo
87106
Intervention_Pharmacological
ibutilide
87107
Intervention_Pharmacological
procainamide .
87108
Intervention_Pharmacological
ibutilide
87109
Intervention_Pharmacological
procainamide
87110
Outcome_Other
pacing-induced termination of atrial flutter
87111
Outcome_Physical
sinus rhythm .
87112
Outcome_Physical
incidence of pacing-induced atrial fibrillation . The atrial flutter cycle length
87113
Outcome_Physical
atrial monophasic action potential duration
87114
Outcome_Physical
tachycardia cycle length nor action potential duration
87115
Outcome_Physical
termination of atrial flutter by atrial overdrive pacing .
87116
Participant_Condition
atrial flutter
87117
Participant_Sample-size
54