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ABSTRACT 55
INTEREST AND LIMITS OF IBUTILIDE FUMARATE TO
TREAT POSTCARDIOTOMY ATRIAL FIBRILLATION.
Philippe Gersbach, Ludwig K. von Segesser, Cardiovascular
Surgery, University Hospital Lausanne, Switzerland.
The absence of negative inotropic effect and the fast onset
of action of Ibutilide fumarate (IF) made this antiarythmic drug
especially attractive to treat postcardiotomy atrial fibrillation.
Methods: 40 patients with early (<72 hours) postoperative
atrial fibrillation were randomly assigned to a treatment of
either 1-2 mg intravenous IF in 30 minutes, or to Amiodarone 2.400-3600
mg intravenously in 72 hours followed by 200 mg orally for 3 months.
Results: Both groups were similar for age, gender, heart
function and type of surgery.
|
Parameter
|
Amiodarone
|
Ibutilide
|
® p
|
|
Early success
|
17/20 = 85%
|
12/20 = 60%
|
<0.05
|
|
Final success
|
17/20 = 85%
|
7/20 = 35%
|
<0.01
|
|
ICU (hours)
|
38.5 ± 31.7
|
7.25 ± 7.3
|
<0.05
|
|
Complications
|
ESV ** 2X
|
ESV ## 2X
|
ns
|
** monomorphic / ## polymorphic ventricular extrasystoles.
® two-tailed Fisher's t-test/ ANOVA
Conclusions: IF is a fast acting drug which allows a significant
reduction of the period of hemodynamic instability and monitoring
time. Its early success rates are, however, less than for Amiodarone,
and complementary treatments seem necessary to avoid early return
to atrial fibrillation.
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