{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:06:32Z","timestamp":1760238392272,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T00:00:00Z","timestamp":1653696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the cardioversion success of ibutilide and amiodarone in patients with post-ablation atrial tachyarrhythmia. We included all episodes of post-ablation atrial tachyarrhythmia in patients treated with either intravenous ibutilide or amiodarone at an academic emergency department from 2010 to 2018. The primary endpoint was the conversion to sinus rhythm. The conversion rates were stratified by arrhythmia type, and multivariable cluster-adjusted logistic regression was used to estimate the effect of ibutilide and amiodarone on cardioversion success, given as the odds ratio (OR) with 95% confidence intervals (95% CI). In total, 109 episodes of 72 patients were analyzed. The conversion rates were 37\/49 (76%) for ibutilide and 16\/60 (27%) for amiodarone. Compared to amiodarone, ibutilide was associated with higher odds of conversion (multivariable cluster-adjusted OR 5.6, 95% CI 1.3\u201324.3). The cardioversion success of ibutilide was the highest in atrial flutter (crude OR 19.5, 95% CI 3.4\u2013112.5) and focal atrial tachycardia (crude OR 8.3, 95% CI 1.5\u201347.2), but it was less pronounced in atrial fibrillation (crude OR 4.5, 95% CI 1.2\u201317.2). Randomized trials are warranted to confirm our findings.<\/jats:p>","DOI":"10.3390\/ijerph19116606","type":"journal-article","created":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T08:50:51Z","timestamp":1653814251000},"page":"6606","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardioversion of Post-Ablation Atrial Tachyarrhythmia with Ibutilide and Amiodarone: A Registry-Based Cohort Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6095-4899","authenticated-orcid":false,"given":"Filippo","family":"Cacioppo","sequence":"first","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2741-6877","authenticated-orcid":false,"given":"Michael","family":"Schwameis","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikola","family":"Schuetz","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1538-9886","authenticated-orcid":false,"given":"Julia","family":"Oppenauer","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0057-8200","authenticated-orcid":false,"given":"Sebastian","family":"Schnaubelt","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Simon","sequence":"additional","affiliation":[{"name":"Clinic Ottakring, Department of Emergency Medicine, Montleartstra\u00dfe 37, 1160 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Lutnik","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Clinical Pharmacology, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Gupta","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Roth","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1329-6149","authenticated-orcid":false,"given":"Harald","family":"Herkner","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-2703","authenticated-orcid":false,"given":"Alexander Oskar","family":"Spiel","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"},{"name":"Clinic Ottakring, Department of Emergency Medicine, Montleartstra\u00dfe 37, 1160 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton Norbert","family":"Laggner","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Domanovits","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2077-2270","authenticated-orcid":false,"given":"Jan","family":"Niederdoeckl","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Emergency Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jacc.2014.03.022","article-title":"2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society","volume":"64","author":"January","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e004549","DOI":"10.1161\/JAHA.112.004549","article-title":"Long-term outcomes of catheter ablation of atrial fibrillation: A systematic review and meta-analysis","volume":"2","author":"Ganesan","year":"2013","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s10840-018-0340-4","article-title":"Very long-term outcomes after a single catheter ablation procedure for the treatment of atrial fibrillation-the protective role of antiarrhythmic drug therapy","volume":"52","author":"Mesquita","year":"2018","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.ijcard.2021.07.053","article-title":"The association between late-phase early recurrence within the blanking period after atrial fibrillation catheter ablation and long-term recurrence: Insights from a large-scale multicenter study","volume":"341","author":"Onishi","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10840-021-01011-0","article-title":"Treatment success and its predictors as well as the complications of catheter ablation for atrial fibrillation in a high-volume centre","volume":"63","author":"Numminen","year":"2022","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s10840-020-00741-x","article-title":"Significance of early recurrence of atrial fibrillation after catheter ablation: A nationwide Danish cohort study","volume":"60","author":"Hodges","year":"2021","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1111\/j.1540-8167.2010.01831.x","article-title":"Clinical significance of early recurrences of atrial tachycardia after atrial fibrillation ablation","volume":"21","author":"Choi","year":"2010","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1016\/j.jacc.2007.07.044","article-title":"Atrial tachycardia after circumferential pulmonary vein ablation of atrial fibrillation: Mechanistic insights, results of catheter ablation, and risk factors for recurrence","volume":"50","author":"Chae","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.hrthm.2007.05.008","article-title":"Surface electrocardiogram characteristics of atrial tachycardias occurring after pulmonary vein isolation","volume":"4","author":"Gerstenfeld","year":"2007","journal-title":"Heart Rhythm"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.hrthm.2004.08.009","article-title":"Late recurrent arrhythmias after ablation of atrial fibrillation: Incidence, mechanisms, and treatment","volume":"1","author":"Kobza","year":"2004","journal-title":"Heart Rhythm"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e007273","DOI":"10.1161\/CIRCEP.119.007273","article-title":"Mechanism of Recurrence of Atrial Tachycardia: Comparison Between First Versus Redo Procedures in a High-Resolution Mapping System","volume":"13","author":"Takigawa","year":"2020","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_13","first-page":"99","article-title":"Ibutilide, a new compound with potent class III antiarrhythmic activity, activates a slow inward Na+ current in guinea pig ventricular cells","volume":"262","author":"Lee","year":"1992","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"689","DOI":"10.7326\/0003-4819-122-9-199505010-00008","article-title":"Amiodarone: Reevaluation of an old drug","volume":"122","author":"Podrid","year":"1995","journal-title":"Ann. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.annemergmed.2017.07.481","article-title":"Ibutilide Effectiveness and Safety in the Cardioversion of Atrial Fibrillation and Flutter in the Community Emergency Department","volume":"71","author":"Vinson","year":"2018","journal-title":"Ann. Emerg. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.ijcard.2006.07.017","article-title":"Conversion efficacy of intravenous ibutilide compared with intravenous amiodarone in patients with recent-onset atrial fibrillation and atrial flutter","volume":"118","author":"Kafkas","year":"2007","journal-title":"Int. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/MEJ.0000000000000361","article-title":"Prognosis of overt disseminated intravascular coagulation in patients admitted to a medical emergency department","volume":"24","author":"Schwameis","year":"2017","journal-title":"Eur. J. Emerg. Med."},{"key":"ref_18","first-page":"e506","article-title":"2015 ACC\/AHA\/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"133","author":"Page","year":"2016","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3036","DOI":"10.1161\/01.CIR.0000147186.83715.95","article-title":"Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation: A prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach","volume":"110","author":"Pappone","year":"2004","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0167-5273(02)00477-1","article-title":"Amiodarone for pharmacological cardioversion of recent-onset atrial fibrillation","volume":"89","author":"Khan","year":"2003","journal-title":"Int. J. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jacc.2010.07.046","article-title":"A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation","volume":"57","author":"Camm","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC)","volume":"41","author":"Brugada","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/0167-5273(92)90058-B","article-title":"Efficacy and safety of short intravenous amiodarone in supraventricular tachyarrhythmias","volume":"35","author":"Veglio","year":"1992","journal-title":"Int. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/j.1540-8159.2006.00353.x","article-title":"Efficacy and safety of ibutilide for the conversion of monomorphic atrial tachycardia","volume":"29","author":"Eidher","year":"2006","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1161\/01.CIR.90.3.1262","article-title":"Sustained atrial tachycardia in adult patients. Electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation","volume":"90","author":"Chen","year":"1994","journal-title":"Circulation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1111\/j.1540-8167.2006.00413.x","article-title":"Narrow, slow-conducting isthmus dependent left atrial reentry developing after ablation for atrial fibrillation: ECG characterization and elimination by focal RF ablation","volume":"17","author":"Shah","year":"2006","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1540-8167.2008.01373.x","article-title":"A deductive mapping strategy for atrial tachycardia following atrial fibrillation ablation: Importance of localized reentry","volume":"20","author":"Jais","year":"2009","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.ijcard.2003.04.034","article-title":"Female preponderance in ibutilide-induced torsade de pointes","volume":"95","author":"Gowda","year":"2004","journal-title":"Int. J. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S0002-9149(96)00566-8","article-title":"Safety and risk\/benefit analysis of ibutilide for acute conversion of atrial fibrillation\/flutter","volume":"78","author":"Kowey","year":"1996","journal-title":"Am. J. Cardiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6606\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:20:38Z","timestamp":1760138438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,28]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19116606"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19116606","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,5,28]]}}}