Division of Pharmacy (CLB), Departments of Cardiology (RA, J-BD) and Biostatistics (DLU), University of Texas MD Anderson Cancer Center, Houston, Texas; and Division of Cardiovascular Medicine (DJL), Vanderbilt University, Nashville, Tennessee.
Am J Med Sci. 2014 Apr;347(4):277-81. doi: 10.1097/MAJ.0b013e31828a7656.
Atrial fibrillation and atrial flutter (AF/AFL) are the most common arrhythmias encountered in clinical practice. Rate versus rhythm control remains a difficult decision, especially in the acute setting. Ibutilide is a class III antiarrhythmic indicated for pharmacological cardioversion of recent-onset AF/AFL. At the University of Texas MD Anderson Cancer Center, restoration of sinus rhythm is desirable because many patients have contraindications to anticoagulation. In addition, most are on multiple medications that prolong the QT interval; therefore, the objective of this study was to establish the safety and efficacy of ibutilide.
This was a retrospective chart review of 81 patients who were identified via the pharmacy database as receiving ibutilide for AF/AFL from January 2002 to May 2006. Outcomes including cardioversion rates and effects on the QT interval were recorded.
Ibutilide use was associated with successful cardioversion in 75% of patients. Out of 81 patients, 68 patients (84%) were on at least 1 medication that prolonged the QT interval at the time of ibutilide administration. However, no significant changes in the corrected QT interval pre and post ibutilide cardioversion were noted in any group of patients.
Overall, ibutilide is safe and effective in cancer patients when used for acute cardioversion of AF/AFL. Despite the use of multiple medications that can potentially prolong the QT interval, no patient experienced serious life-threatening rhythm disturbances or significant QT prolongation during ibutilide administration.
心房颤动和心房扑动（AF/AFL）是临床实践中最常见的心律失常。在急性情况下，控制心率与控制节律仍然是一个困难的决策。伊布利特是一种 III 类抗心律失常药物，用于治疗新发的 AF/AFL。在德克萨斯大学 MD 安德森癌症中心，恢复窦性心律是理想的，因为许多患者有抗凝治疗的禁忌证。此外，大多数患者正在服用多种延长 QT 间期的药物；因此，本研究的目的是确定伊布利特的安全性和有效性。
这是一项回顾性图表研究，共纳入 81 例于 2002 年 1 月至 2006 年 5 月期间因 AF/AFL 而接受伊布利特治疗的患者。记录了转复率和 QT 间期的影响等结局。
伊布利特的使用使 75%的患者成功转复为窦性心律。在 81 例患者中，有 68 例（84%）在接受伊布利特治疗时至少服用了一种延长 QT 间期的药物。然而，在任何一组患者中，伊布利特转复前后的校正 QT 间期均无显著变化。
总的来说，伊布利特在用于癌症患者急性 AF/AFL 转复时是安全有效的。尽管使用了多种可能延长 QT 间期的药物，但在伊布利特治疗期间，没有患者出现严重的危及生命的心律失常或 QT 间期显著延长。
