Keywords

atrial fibrillation, atrial flutter, ibutilide, torsades de pointes, ventricular fibrillation

 

Authors

  1. Giudici, Michael C. MD
  2. Fischer, William J. III BS
  3. Cervantes, David C. BS
  4. Schrumpf, Phillip E. RN
  5. Paul, Deborah L. RTR
  6. Sentman, Kristin E. MD
  7. Serra, Victoria L. MD
  8. Barold, S. Serge MD

Abstract

Many institutions restrict the use of ibutilide because of the potential risk of polymorphic ventricular tachycardia (PMVT). Over a 5-year period from June 2000 to May 2005, 238 patients, 151 men and 87 women, with a mean age of 67.1 years (range, 22-94 years), received intravenous ibutilide at our institution. Ibutilide was administered by nurses or physicians in 4 clinical settings: emergency department (n = 80), intensive care unit (n = 11), patient room on telemetry (n = 107), and in the cardiac catheterization/electrophysiology laboratory (n = 40). Conversion to sinus rhythm occurred in 59% of patients outside the catheterization/electrophysiology laboratory. The incidence of PMVT was 1.7%. Three patients had brief nonsustained PMVT and 1 patient had a sustained PMVT. There was no difference in outcome whether a physician was present at the time of ibutilide administration. Our data suggest that ibutilide is a safe and efficacious drug when ordered by experienced physicians in properly selected patients in a variety of monitored settings.