Electrophysiological Effects of Ibutilide in Patients With Accessory Pathways

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Abstract
Background Atrial fibrillation (AF) may cause life-threatening ventricular arrhythmias in patients with Wolff-Parkinson-White syndrome. We prospectively evaluated the effects of ibutilide on the conduction system in patients with accessory pathways (AP). Methods and Results In part I, we gave ibutilide to 22 patients (18 men, 31±13 years of age) who had AF during electrophysiology study, including 6 pediatric patients ≤18 years of age. Ibutilide terminated AF in 21 of 22 patients (95%) during or 8±5 minutes after infusion and prolonged the shortest preexcited R-R interval during AF. Successful ablation was performed in all patients. In part II, ibutilide was given to 18 patients (14 men, 28±21 years) to assess its effects on the AP and conduction system. Ibutilide prolonged the antegrade atrioventricular node effective refractory period (ERP) (from 252±60 to 303±70 ms;PPConclusions We report the use of ibutilide in terminating AP-mediated AF, including the first report in the pediatric population. Ibutilide prolonged refractoriness of the atrioventricular node, His-Purkinje system, and AP.

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