Concurrent administration of propafenone and ibutilide -- both used to treat cardiac arrhythmia -- for the treatment of persistent atrial fibrillation (AF) is more effective than treatment with ibutilide alone, according to a study published in the British medical journal Heart. The research was conducted at the University of Ioannina Medical School and the General Hospital of Corfu, both in Greece.
In the study, 100 patients with persistent AF admitted for elective pharmacological cardioversion -- drug-based heartbeat regulation -- were randomly assigned to treatment with either intravenous ibutilide or oral propafenone plus intravenous ibutilide at the same dose. Forty-one percent of patients treated with ibutilide alone experienced AF improvement, compared to 71 percent of those given propafenone plus ibutilide.
However, researchers observed, cardioversion occurred earlier in the ibutilide-alone group compared with the combination group. One case of sustained torsade de pointes -- a type of ventricular tachycardia -- was observed in the propafenone-plus-ibutilide group, and required electrical cardioversion (restoration of the heartbeat's natural pace by using an electroshock device). No other complications were observed during the hospitalization period.