Pre-injection of magnesium sulfate enhances the efficacy of ibutilide for the conversion of typical but not of atypical persistent atrial flutter

International Journal of Cardiology
Clemens SteinwenderRobert Hofmann

Abstract

Ibutilide is a class III antiarrhythmic drug, frequently used for conversion of atrial fibrillation and flutter. Retrospective cohort evaluations found that intravenous application of magnesium enhances the efficacy of ibutilide for chemical conversion of these arrhythmias. This prospective study sought to investigate the effects of intravenously pre-injected magnesium on the conversion rate of ibutilide for typical and atypical atrial flutter. We performed a prospective, randomized, placebo-controlled study. Patients with typical atrial flutter (TAF) or atypical atrial flutter (AAF) were randomized to receive either 4 g of intravenous magnesium sulfate or placebo immediately before administration of a maximum dose of 2 mg of ibutilide fumarate. Continuous rhythm monitoring for 4 h provided information on conversion to sinus rhythm. QT interval durations were measured before randomization, after magnesium, as well as 30 min and 4 h after starting ibutilide infusion. We randomized 117 patients (58 with and 59 without pre-injection of magnesium; 65 with TAF and 52 with AAF). In patients with TAF, pre-injection of magnesium significantly improved the efficacy of ibutilide for conversion (85% with magnesium vs. 59% with placebo, p=...Continue Reading

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Citations

Nov 2, 2011·Emergency Medicine Clinics of North America·Laura J Bontempo, Eric Goralnick
Jun 5, 2013·Pacing and Clinical Electrophysiology : PACE·Harsha V GangaJeffrey Kluger
Aug 1, 2015·Emergency Medicine Clinics of North America·Eric Goralnick, Laura J Bontempo
Oct 22, 2016·European Heart Journal. Cardiovascular Pharmacotherapy·William L Baker

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