What is the role of ibutilide in the treatment of atrial flutter (AFL)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Ibutilide [17, 18, 19, 20] is also effective, converting recent-onset atrial flutter to sinus rhythm in 63% of patients with a single infusion. It is the only agent available in the United States that can be used intravenously for cardioversion. Because of the risk of QT prolongation and torsade de pointes, it must be given in a monitored setting. Continuous electrocardiographic (ECG) monitoring is indicated for at least 4 hours after infusion. Ibutilide should not be used in patients with severe chronic heart failure, hypokalemia, or baseline prolonged QT.

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