II. Indications
-
Atrial Fibrillation Chemical Cardioversion
- Consider in combination with Electrical Synchronized Cardioversion of Atrial Fibrillation
III. Contraindications
- QTc Prolongation (or QT >500 msec)
- Severe Left Ventricular Dysfunction
- Combination with Class 1a or Class III Antiarrhythmics
IV. Mechanism
- Class III Antiarrhythmic
V. Precautions
- Cardiac monitoring on starting Ibutilide
- Monitor for a minimum of 4 hours after drug administration
- Continue monitoring until QTc Interval normalizes
- Correct Electrolyte abnormalities before starting Ibutilide (and continue to monitor Electrolyte levels)
VI. Dosing
- Initial
- Weight <60 kg: 0.01 mg/kg IV over 10 min
- Weight >60 kg: 1 mg IV over 10 min
- Subsequent
- May repeat once after 10 min if not converted to sinus rhythm with first dose
- Stop infusion on conversion to sinus rhythm
VII. Adverse Effects
- Significantly proarrhythmic
- Ventricular Tachycardia or fibrillation risk: 1-2%
- Requires EKG monitoring for 4 hours after dose
-
Prolonged QTc
- Risk of Torsades de Pointes
- Observe in monitored setting
VIII. Efficacy
-
Atrial Fibrillation Cardioversion
- Time to Cardioversion: 1 hour
- Conversion Rate: 33-45% (60% in Atrial Flutter)
IX. Safety
- Unknown safety in Lactation
- Pregnancy Category C
X. Resources
- Ibutilide Injection Solution (DailyMed)
- Ibutilide (Stat Pearls)
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Related Studies
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C067192 |
SnomedCT | 108491000, 372500009 |
English | ibutilide, N-(4-(4-(ethylheptylamino)-1-hydroxybutyl)phenyl)methanesulfonamide, ibutilide [Chemical/Ingredient], IBUTILIDE, Ibutilide (product), Ibutilide (substance), Ibutilide |
Spanish | ibutilida (producto), ibutilida (sustancia), ibutilida |
Ontology: Corvert (C0644117)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | C067192 |
English | Pfizer brand of ibutilide fumarate, Corvert |