Objectives To evaluate the efficiency and security of ibutilide, which is combinedly used to patients through intravenous injection, who have amiodarone per os without converting AFL/AF(< 365 days).
Methods Selected 88 patients who were eligible for the group conditions. The control group (A) using ibutilide alone, The experimental group (B), take Ibutilide and amiodarone P. O. in combination. Test are all normal, amiodarone oral load is 7-15g (2-4 weeks). the first dose of Ibutilide is 1.0mg, slow injected within 10 min. If needed, take the second injection after 10 min. Observe the change of ECG, the converting rate of cardioversion, the dosage change during cardioversion process, the difference in the QT interval before and after injecting drug and the incidence of adverse events within 4 hours.
Results (1)The B group the success rate of AFL is higher than those in the A group (92.3%VS55.6%, P = 0.116), However, the success rate of AF converting was statistically significance (75.6%VS44.0%, P = 0.010), the total success rate of two groups of AFL/AF converting was statistically significant (79.6%VS47.1%, P = 0.003); (2)The dosage of idutilide of AFL converting successfully is lower than AF (1.12 ± 0.45 mg vs. 1.69 ± 0.44 mg, P < 0.01); (3) The QTc difference between B group and A group has no statistically significant (0.49 ± 0.08 vs. 0.43 ± 0.04, P = 0.760) before using ibutilide; and the same after using ibutilide (0.52 ± 0.06 vs. 0.45 ± 0.03, P = 0.150); (4) There was 1 patient in B group occurred VT during the process of pushing drug, 2.5 gMgSO4 terminated the VT; There was 1 patient in B group suffering VT after converting success 5 minutes later, and stopped by herself. There were 2 patients occurred arrest each in the two groups, all restoring sinus rhythm after 2-3 seconds by the chest outside pressing or by themselves.
Conclusions The converting success rate by combine medication is higher than that by alone medication, and combine medication of ibutilide and amiodarone can prevent the recurrence; the combination did not increase the incidence of adverse events. Therefore, the two drugs combinedly used to convert AFL/AF is safe and effective. It is worth to be careful promotion.