title: Efficacy and safety of ibutilide vs. transoesophageal atrial pacing for the termination of type I atrial flutter.
abstract: OBJECTIVE
  Comparing efficacy and safety of ibutilide vs. transoesophageal atrial pacing (ATP) for the termination of type I atrial flutter (AFL).
  
  
  RESULTS
  Eighty-seven patients affected by AFL lasting between 2 h and 30 days were randomized in two groups: Group 1-i.v. ibutilide treatment, up to 2 mg, and Group 2-ATP, with "burst" and "ramp" pacing protocols. Sinus rhythm was restored in 36/45 (80%) patients in Group 1 vs. 18/42 (43%) in Group 2 (P<0.0005). In Group 1, mean AFL duration was 11.4 +/- 7.7 days in responders vs. 12.1 +/- 7.6 in non-responders (P=ns), while in Group 2 it was 2.7 +/- 1.4 vs. 14.2 +/- 5.4 days (responders vs. non-responders, respectively, P<0.0001); 30/36 (83%) responders in Group 1 had AFL >48 h vs. 10/18 (56%) responders in Group 2 (P<0.05). Non-sustained polymorphic ventricular tachycardia occurred in 2 patients in Group 1 vs. none in Group 2 (P=ns). It did not require any specific treatment except the interruption of ibutilide infusion.
  
  
  CONCLUSIONS
  Both ibutilide and ATP proved to be safe and effective for recent onset type I AFL termination, but ibutilide was more effective when the arrhythmia had lasted longer than 48 h.
authors.affiliation: I Division of Cardiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazza
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Fera
authors.forename: Irma
authors.initials: I
authors.lastname: Bisceglia
authors.forename: Francesca
authors.initials: F
authors.lastname: Bettiol
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pulignano
authors.forename: Pietro
authors.initials: P
authors.lastname: Tanzi
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
authors.forename: Ezio
authors.initials: E
authors.lastname: Giovannini
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001282:Atrial Flutter / Q000188:drug therapy / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D013449:Sulfonamides; C067192:ibutilide