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Review
. 2012 Feb 2;4(5):500.
doi: 10.4022/jafib.500. eCollection 2012 Feb-Mar.

Conversion of Persistent Atrial Fibrillation After Radiofrequency Ablation by Ibutilide

Affiliations
Review

Conversion of Persistent Atrial Fibrillation After Radiofrequency Ablation by Ibutilide

Pipin Kojodjojo. J Atr Fibrillation. .

Abstract

Ablation of peristent AF remains challenging with questions unanswered about what the ideal next step after pulmonary venous isolation should be. Ibutilide is a highly effective class III agent for cardioversion of acute-onset atrial flutter and fibrillation, with limited clinical use due to risks of ventricular pro-arrhythmias. However, results from the on-going MAGIC-AF trial may re-invigorate its role in clinical electrophysiology as an invaluable adjunct to facilitate controlled substrate modification during ablation of persistent AF.

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Figures

Figure 1.
Figure 1.. Reduction in mean AF cycle length before (above panel) and after (below panel) ibutilide. Purple areas represent regions with mean cycle length in excess of 120ms and red areas represent areas with shortest cycle length. Note the reduction in area of CFAE, resulting in a more compact area targeted for ablation. (Adopted from Singh et al. Intraprocedural use of ibutilide to organise and guide ablation of complex fractionated atrial electrograms. J Cardiovasc. Electrophysiol. 201; 21(6): 608-615)

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