Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China.
Department of Cardiovascular Medicine, The First Hospital of Fuzhou, Fuzhou, 350000, Fujian Province, China.
BMC Cardiovasc Disord. 2024 Feb 20;24(1):118. doi: 10.1186/s12872-024-03787-1.
To assess the efficacy of ibutilide administration during radiofrequency catheter ablation of persistent atrial fibrillation (AF), to explore the success rate of conversion and related influential factors, and to analyze the effects of ibutilide on postoperative recurrence.
A total of 192 patients with persistent AF who underwent catheter ablation from January 1, 2019, to December 31, 2021. These patients failed in conversion of AF to normal sinus rhythm by intraoperative catheter ablation. Patients were categorized into effective group (115 cases) and ineffective group (77 cases) based on whether sinus rhythm was restored after application of ibutilide.
The overall success rate of conversion using ibutilide administration was 59.9%. The success rate was associated with weight ((68.12 ± 11.72 vs. 72.83 ± 12.08) kg, P = 0.008), the duration of AF ((34.67 ± 55.68 vs. 66.52 ± 95.21) months, p = 0.008), diameter of left atrium (LAD) ((44.39 ± 5.80 vs. 47.36 ± 6.10) mm,P = 0.002), and N-terminal pro-brain natriuretic peptide (NT-proBNP) level ((854.85 ± 770.84 vs. 662.88 ± 659.18) pg/ml,P = 0.030). The results showed the duration of AF was associated with early recurrence, while early recurrence was not a risk factor for late recurrence. And duration of AF was associated with postoperative maintenance time of normal sinus rhythm, whereas successful conversion into normal sinus rhythm using ibutilide administration had no influence on postoperative maintenance time of normal sinus rhythm.
Ibutilide showed to be effective in catheter ablation of AF, the success rate of conversion was correlated with the duration of AF, LA diameter, and NT-proBNP level. Besides, the duration of AF was found as a risk factor for early postoperative recurrence, while ibutilide administration for successful conversion had no influence on predicting postoperative recurrence and had no influence on postoperative maintenance time of sinus rhythm.
评估伊布利特在持续性心房颤动（AF）射频导管消融中的疗效，探讨转复成功率及相关影响因素，并分析伊布利特对术后复发的影响。
选择 2019 年 1 月 1 日至 2021 年 12 月 31 日行导管消融的 192 例持续性 AF 患者，术中导管消融未能将 AF 转为窦性心律，术后应用伊布利特，根据窦性心律恢复情况分为有效组（115 例）和无效组（77 例）。
伊布利特转复总有效率为 59.9%。转复成功率与体重（（68.12±11.72）kg 比（72.83±12.08）kg，P=0.008）、AF 持续时间（（34.67±55.68）月比（66.52±95.21）月，P=0.008）、左心房内径（LAD）（（44.39±5.80）mm 比（47.36±6.10）mm，P=0.002）、N 末端脑钠肽前体（NT-proBNP）水平（（854.85±770.84）pg/ml 比（662.88±659.18）pg/ml，P=0.030）有关。结果显示，AF 持续时间与早期复发有关，而早期复发不是晚期复发的危险因素。AF 持续时间与术后窦性节律维持时间有关，而伊布利特转复为窦性节律对术后窦性节律维持时间无影响。
伊布利特在 AF 导管消融中有效，转复成功率与 AF 持续时间、左心房直径和 NT-proBNP 水平有关。此外，AF 持续时间是术后早期复发的危险因素，而伊布利特转复成功对预测术后复发无影响，对术后窦性节律维持时间无影响。
