Ibutilide

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 (physiology) of myocardial cells. Because of its Class III antiarrhythmic activity, there should be caution for proarrhythmic effects and it should be used in a setting with continuous ECG monitoring and by personnel trained in identification and treatment of acute ventricular arrhythmias, particularly torsade de pointes (TdP).

Etymology

The name "Ibutilide" is derived from its chemical name, which is N-[4-[4-(ethylheptylamino)-1-hydroxybutyl]phenyl]methanesulfonamide.

Pharmacology

Ibutilide works by activating a specific type of ion channel in the heart, leading to a prolongation of the cardiac action potential. This action potential prolongation is associated with a delay in the repolarization of the heart's electrical system, which can promote the conversion of abnormal heart rhythms back to normal rhythms.

Clinical Use

Ibutilide is used in the clinical setting primarily to treat atrial fibrillation and atrial flutter, two common types of abnormal heart rhythm. It is administered intravenously and its effects are usually seen within 30 minutes of administration.

Side Effects

The most serious side effect of ibutilide is a type of abnormal heart rhythm called torsades de pointes. This can lead to a serious condition known as ventricular fibrillation, which is a medical emergency. Other side effects can include headache, irregular heartbeats, and low blood pressure.

Related Terms

• Antiarrhythmic agent
• Atrial fibrillation
• Atrial flutter
• Torsades de pointes
• Ventricular fibrillation

References

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