{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:29:48Z","timestamp":1787315388095,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2001,1,16]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    \u2014Ibutilide is a class III drug that is used for the cardioversion of atrial arrhythmias, but it can cause torsade de pointes. Amiodarone also prolongs the QT interval but rarely causes torsade de pointes. There are no studies in which the concomitant use of the 2 agents was examined. The purpose of the present study was to assess the efficacy and safety of cardioversion with combination therapy in patients with atrial fibrillation or flutter.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    \u2014The study included 70 patients who were treated with long-term oral amiodarone and were referred for elective cardioversion of atrial fibrillation (57 of 70, 81%) or flutter (13 of 70, 19%). Patients were taking amiodarone (153\u00b1259 days, mean\u00b1SD) and were administered 2 mg intravenous ibutilide. Left ventricular ejection fraction was measured with echocardiography. The QT intervals were measured on 12-lead ECG. Fifty-five patients (79%) had structural heart disease. Patients were in arrhythmia for 196\u00b1508 days before cardioversion, with a left ventricular ejection fraction of 50\u00b111%. In patients with atrial fibrillation, 22 (39%) of 57 and 7 (54%) of 13 patients with flutter converted within 30 minutes of infusion. Thirty-nine patients who did not convert after ibutilide were treated with electrical cardioversion, and 35 (90%) of 39 patients were successfully converted. The QT intervals were further prolonged after ibutilide for the group from 371\u00b161 to 479\u00b192 ms (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). There was 1 episode of nonsustained torsade de pointes (1 of 70, 1.4%) after ibutilide.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    \u2014The use of ibutilide converted 54% of patients with atrial flutter and 39% of patients with atrial fibrillation who were treated with long-term amiodarone. Despite QT-interval prolongation after ibutilide, only 1 episode of torsade de pointes occurred. Our observations suggest that combination therapy may be a useful cardioversion method for chronic atrial fibrillation or flutter.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.103.2.253","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:09:32Z","timestamp":1339445372000},"page":"253-257","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Chemical Cardioversion of Atrial Fibrillation or Flutter With Ibutilide in Patients Receiving Amiodarone Therapy"],"prefix":"10.1161","volume":"103","author":[{"given":"Kathy","family":"Glatter","sequence":"first","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfei","family":"Yang","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanu","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnard","family":"Modin","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Cheng","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Kayser","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin M.","family":"Scheinman","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Research Institute and Section of Cardiac Electrophysiology (K.G., Y.Y., K.C., G.M., S.K., M.M.S.), University of California, San Francisco; and Section of Cardiac Electrophysiology (J.C.), State University of New York-Syracuse."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.6.1799"},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-199502000-00021"},{"key":"e_1_3_3_3_2","first-page":"H1269","volume":"264","year":"1993","unstructured":"Wesley RC, Farkhani F, Morgan D, et al. Ibutilide: enhanced defibrillation via plateau sodium current activation. Am J Physiol. 1993;264:H1269\u2013H1274.","journal-title":"Am J Physiol"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.5.493"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.94.7.1499"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.96.12.4298"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00078-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(96)00121-0"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.19.1935"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.94.7.1613"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.100.4.369"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199243010-00007"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.80.1.2736754"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90582-7"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-121-7-199410010-00009"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-111-7-574"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199906173402401"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00210-0"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00927-2"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90654-8"},{"key":"e_1_3_3_21_2","unstructured":"Glantz SA. Primer of Biostatistics. 4th ed. New York NY: McGraw-Hill; 1997:65\u2013107."},{"key":"e_1_3_3_22_2","unstructured":"Cronbach LJ Gleser GC Nanda H et al. The Dependability of Behavioral Measurements: Theory of Generalizability for Scores and Profiles. New York NY: Wiley; 1972."},{"key":"e_1_3_3_23_2","unstructured":"Dixon WJ ed. BMDP Statistical Software Manual. Berkeley Calif: University of California Press; 1988."},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90529-0"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.98.18.1928"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.98.18.1921"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1997.tb01018.x"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90205-4"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.103.2.253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T09:19:36Z","timestamp":1715505576000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.103.2.253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,1,16]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2001,1,16]]}},"alternative-id":["10.1161\/01.CIR.103.2.253"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.103.2.253","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,1,16]]},"assertion":[{"value":"2000-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-08-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2001-01-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}