Ibutilide: An Option for Cardioversion of New-Onset AFib in the ED?

Many patients who present to the emergency department with new-onset atrial fibrillation meet criteria for consideration of cardioversion in the ED, thus having sinus rhythm restored and avoiding admission. Researchers assessed the safety and efficacy of outpatient management of new-onset atrial arrhythmia with ibutilide, a relatively new type III antiarrhythmic drug that is approved for both atrial fibrillation and atrial flutter. Ibutilide prolongs the refractory period in the atria and lengthens the QT interval in the ventricles. It is rapid acting, has a short half-life (approximately 4 hours), and has limited interactions with rate control medications.

Investigators prospectively enrolled consecutive patients with new-onset palpitations…