{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T22:24:34Z","timestamp":1787264674536,"version":"build-2736575974"},"reference-count":36,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1997,11,24]]},"published-print":{"date-parts":[[1998,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To compare the efficacy and safety of a single dose of ibutilide, a new class III antiarrhythmic drug, with that of\n                      <jats:sc>dl<\/jats:sc>\n                      -sotalol in terminating chronic atrial fibrillation or flutter in haemodynamically stable patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Double blind, randomised study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>43 European hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>\n                      308 patients (mean age 60 years, 70% men, 48% with heart disease) with sustained atrial fibrillation (n\u2009=\u2009251) or atrial flutter (n\u2009=\u200957) (duration three hours to 45 days) were randomised to three groups to receive a 10 minute infusion of 1\u2009mg ibutilide (n\u2009=\u200999), 2\u2009mg ibutilide (n\u2009=\u2009106), or 1.5\u2009mg\/kg\n                      <jats:sc>dl<\/jats:sc>\n                      -sotalol (n\u2009=\u2009103). Infusion was discontinued at termination of the arrhythmia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Successful conversion of atrial fibrillation or flutter, defined as termination of arrhythmia within one hour of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both drugs were more effective against atrial flutter than against atrial fibrillation. Ibutilide was superior to\n                      <jats:sc>dl<\/jats:sc>\n                      -sotalol for treating atrial flutter (70% and 56%\n                      <jats:italic>v<\/jats:italic>\n                      19%), while the high dose of ibutilide was more effective for treating atrial fibrillation than\n                      <jats:sc>dl<\/jats:sc>\n                      -sotalol (44%\n                      <jats:italic>v<\/jats:italic>\n                      11%) and the lower dose of ibutilide (44%\n                      <jats:italic>v<\/jats:italic>\n                      20%, p\u2009&lt;\u20090.01). The mean (SD) time to arrhythmia termination was 13 (7) minutes with 2\u2009mg ibutilide, 19 (15) minutes with 1\u2009mg ibutilide, and 25 (17) minutes with\n                      <jats:sc>dl<\/jats:sc>\n                      -sotalol. In all patients, the duration of arrhythmia before treatment was a predictor of arrhythmia termination, although this was less obvious in the group that received 2\u2009mg ibutilide. This dose converted almost 48% of atrial fibrillation that was present for more than 30 days. Concomitant use of digitalis or nifedipine and prolongation of the QTc interval were not predictive of arrhythmia termination. Bradycardia (6.5%) and hypotension (3.7%) were more common side effects with\n                      <jats:sc>dl<\/jats:sc>\n                      -sotalol. Of 211 patients given ibutilide, two (0.9%) who received the higher dose developed polymorphic ventricular tachycardia, one of whom required direct current cardioversion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ibutilide (given in 1 or 2\u2009mg doses over 10 minutes) is highly effective for rapidly terminating persistent atrial fibrillation or atrial flutter. This new class III drug, under monitored conditions, is a potential alternative to currently available cardioversion options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/hrt.79.6.568","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"568-575","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":154,"title":["Superiority of ibutilide (a new class III agent) overdl-sotalol in converting atrial flutter and atrial fibrillation"],"prefix":"10.1136","volume":"79","author":[{"given":"M A","family":"Vos","sequence":"first","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S R","family":"Golitsyn","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Stangl","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Y","family":"Ruda","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Van Wijk","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J D","family":"Harry","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K T","family":"Perry","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Touboul","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Steinbeck","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de Lyon, Lyon, France, \n\nhKlinikum Grosehadern of the University of Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J J","family":"Wellens","sequence":"additional","affiliation":[{"name":"aUniversity Hospital, Maastricht, Netherlands, \n\nbCardiology Research Centre, Moscow, Russia, \n\ncHumholdt University, Berlin, Germany, \n\ndSt Chr Ziekenhuis Refaja, Stadskanaal, Netherlands, \n\nePharmacia & Upjohn, Crawley, West Sussex, UK, \n\nfPharmacia & Upjohn, Kalamazoo, Michigan, USA, \n\ngHospitaux de 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