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In patients with persistent atrial fibrillation (AF), the procedural and clinical outcomes of ablation combined with infusion of antiarrhythmic drug are unknown. <jats:italic>Objectives<\/jats:italic>. To determine the impact of low-dose ibutilide after circumferential pulmonary vein isolation (CPVI) and\/or left atrial (LA) substrate modification on acute procedural and clinical outcome of persistent AF. <jats:italic>Methods<\/jats:italic>. In a prospective cohort of 135 consecutive patients with persistent AF, intravenous 0.25\u2009mg ibutilide was administered 3 days before the procedure and intraprocedurally, if required, after CPVI and\/or additional LA substrate modification of sites with continuous, rapid or fractionated, and low-voltage (0.05\u20130.3\u2009mv) atrial activity. <jats:italic>Results<\/jats:italic>. Persistent AF was terminated by CPVI alone (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>15<\/mml:mn><\/mml:mrow><\/mml:math>) or CPVI + ibutilide (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>32<\/mml:mn><\/mml:mrow><\/mml:math>) in 47 (34.8%) patients (CPVI responders). Additional LA substrate modification without (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>33<\/mml:mn><\/mml:mrow><\/mml:math>) or with subsequent administration of 0.25\u2009mg ibutilide (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mrow><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>19<\/mml:mn><\/mml:mrow><\/mml:math>) terminated AF in another 52 (38.5%) patients (substrate modification responders). Sinus rhythm was restored by electrical cardioversion in the remaining 36 (26.7%) patients (nonresponders). The mean LA substrate ablation time was 14 \u00b1 6 minutes. At follow-up of 24 \u00b1 10 months, the rates of freedom from atrial tachyarrhythmias among the responders in CPVI and substrate modification groups were mutually comparable (66.0% and 69.2%) and higher than among the nonresponders (36.1%; <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:mrow><\/mml:math>). Among the responders, there was no difference in clinical outcome between patients whose persistent AF was terminated without or with low-dose ibutilide. <jats:italic>Conclusion<\/jats:italic>. Administration of low-dose ibutilide during ablation of persistent AF may allow select patients wherein substrate ablation is not or minimally required to optimize procedural and clinical outcomes.<\/jats:p>","DOI":"10.1155\/2019\/3210803","type":"journal-article","created":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T08:08:04Z","timestamp":1546416484000},"page":"1-10","source":"Crossref","is-referenced-by-count":5,"title":["Low-Dose Ibutilide Combined with Catheter Ablation of Persistent Atrial Fibrillation: Procedural Impact and Clinical Outcome"],"prefix":"10.1155","volume":"2019","author":[{"given":"Xue-Rong","family":"Sun","sequence":"first","affiliation":[{"name":"Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Tian","sequence":"additional","affiliation":[{"name":"Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, 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