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Ibutilide is a Class III antiarrhythmic agent that is indicated for acute cardioconversion of atrial fibrillation and atrial flutter of a recent onset to sinus rhythm. It exerts its antiarrhythmic effect by induction of slow inward sodium current, which prolongs action potential and refractory period of myocardial cells.
Prevent paroxysmal atrial fibrillation [7] and haemodynamically stable ventricular tachycardia [8] (amiodarone) Treat atrial flutter and atrial fibrillation (ibutilide) Treat ventricular tachycardia and atrial fibrillation (sotalol) Treat Wolff-Parkinson-White syndrome; IV Calcium channel blockers Diltiazem; Verapamil; Ca 2+ channel blocker
However, atrial flutter is more resistant to correction with such medications than atrial fibrillation. [1] For example, although the class III antiarrhythmic agent ibutilide is an effective treatment for atrial flutter, rates of recurrence after treatment are quite high (70–90%). [1]
Amiodarone is an effective, antiarrhythmic-of-choice in achieving cardioversion to sinus rhythm in critical care populations with new onset atrial fibrillation (NOAF). However, other anti-arrhythmic agents may exert superior rhythm control, rate control and lower mortality rate which may be more favourable than amiodarone in specific cases. [32]
Catheter ablation is a procedure that uses radio-frequency energy or other sources to terminate or modify a faulty electrical pathway from sections of the heart of those who are prone to developing cardiac arrhythmias such as atrial fibrillation, atrial flutter and Wolff-Parkinson-White syndrome.
Depending on the patient's health and other variables such as medications taken for rate control, atrial fibrillation may cause heart rates that span from 50 to 250 beats per minute (or even higher if an accessory pathway is present). However, new-onset atrial fibrillation tends to present with rates between 100 and 150 beats per minute. [22]
Those affected by arrhythmogenic cardiomyopathy may not have any symptoms at all despite having significant abnormalities in the structure of their hearts. [6] If symptoms do occur, the initial presentation is often due to abnormal heart rhythms (arrhythmias) which in arrhythmogenic cardiomyopathy may take the form of palpitations, or blackouts. [7]
The main symptom of AVNRT is the sudden development of rapid regular palpitations. [1] These palpitations may be associated with a fluttering sensation in the neck, caused by near-simultaneous contraction of the atria and ventricles against a closed tricuspid valve leading to the pressure or atrial contraction being transmitted backwards into the venous system. [2]
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