Skip to main content
SpringerLink
Log in

Acute Termination of Atrial Flutter: Class III Drugs or Transesophageal Pacing?

  • Conference paper
Cardiac Arrhythmias 2003

  • 64 Accesses

Abstract

Atrial flutter (AFL) is an arrhythmia which occurs frequently. Epidemiological data show an incidence of 88/100 000 new cases per year in the general population in USA, with 200 000 new cases every year [1]. The main predictors of this arrhythmia are heart failure and chronic obstructive pulmonary disease. It often coexists with atrial fibrillation (AF); moreover, it is not unusual that patients undergoing antiarrhythmic treatment with class IC drugs or amiodarone for the treatment of AF develop episodes of AFL. Often AFL is poorly tolerated due to the high ventricular response. This happens even in patients with good control of ventricular rate at rest, who do not tolerate AFL during effort, since ventricular rate increases suddenly.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Granada J, Uribe W, Cyhou PH et al (2000) Incidence and predictors of atrial flutter in the general population. J Am Coll Cardiol 36:2242–2246

    Article  PubMed  CAS  Google Scholar 

  2. Natale A, Newby KH, Pisanö E et al (2000) Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol 35:1898–1904

    Article  PubMed  CAS  Google Scholar 

  3. Bianconi L, Boccadamo R, Pappalardo A et al (1989) Effectiveness of intravenous propafenone for conversion of paroxysmal atrial fibrillation or flutter to sinus rhythm. Am J Cardiol 64:335–338

    Article  PubMed  CAS  Google Scholar 

  4. Suttorp MJ, Kingma JH, Lie-A-Huen L et al (1989) Intravenous flecainide versus verapamil for conversion of paroxysmal atrial fibrillation or flutter to sinus rhythm. Am J Cardiol 63:693–696

    Article  PubMed  CAS  Google Scholar 

  5. Antman EM, Beamer Ad, Cantillon C et al (1990) Therapy of refractory symptomatic atrial fibrillation and atrial flutter: a staged care approach with new antiarrhythmic drugs. J Am Coll Cardiol 15:698–707

    Article  PubMed  CAS  Google Scholar 

  6. Olshansky B (1996) Dofetilide versus quinidine for atrial flutter: vive 1a difference. J Cardiovasc Electrophysiol 7:809–827

    Article  Google Scholar 

  7. Falk RH, Pollak A, Singh SN et al (1997) Intravenous dofetilide, a class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter. J Am Coll Cardiol 29:385–390

    Article  PubMed  CAS  Google Scholar 

  8. Suttorp MJ, Polak PE, Van’t-Hof A et al (1992) Efficacy and safety of a new selective class III antiarrhythmic agent dofetilide in paroxysmal atrial fibrillation or atrial flutter. Am J Cardiol 69:417–418

    Article  PubMed  CAS  Google Scholar 

  9. Bianconi L, Dinelli L, Papalardo A et al (1995) Comparison of intravenously-administered dofetilide vs amiodarone in the acute termination of atrial fibrillation and flutter: a multi-centered randomized, double-blind placebo-controlled study. Circulation 92(Suppl 1):1–775

    Google Scholar 

  10. Singh S, Berk M, Zoble R et al (1998) Oral dofetilide for conversion of patients with chronic atrial fibrillation or atrial flutter to normal sinus rhythm: a multicenter study. J Am Coll Cardiol 31 (Suppl A):369A–370A

    Article  Google Scholar 

  11. Ellenbogen KA, Stambler BS, Wood MA et al (1996) Efficacy of intravenous ibutilide for rapid termination of atrial fibrillation and atrial flutter: a dose-response study. J Am Coll Cardiol 28:130–136

    Article  PubMed  CAS  Google Scholar 

  12. Naccarelli GV, Lee KS, Gibson GK, VanderLugt J (1996) Electrophysiology and pharmacology of ibutilide. Am J Cardiol 78(suppl 8A):12–16

    Article  PubMed  CAS  Google Scholar 

  13. Stambler BS, Wood MA, Ellenbogen KA et al (1996) Efficacy and safety of repeated intravenous doses of ibutilide for rapid conversion of atrial flutter or fibrillation. Circulation 94:1613–1621

    Article  PubMed  CAS  Google Scholar 

  14. Murray KT (1998) Ibutilide. Circulation 97:493–497

    Article  PubMed  CAS  Google Scholar 

  15. Kowey PR, VanderLugt JT, Luderer JR (1996) Safety and risk/benefit analysis of ibutilide for acute conversion of atrial fibrillation/flutter. Am J Cardiol 78(Suppl 8A):46–52

    Article  PubMed  CAS  Google Scholar 

  16. Kowey PR (1997) Use of ibutilide following cardiac surgery. J Am Coll Cardiol 98:633

    Google Scholar 

  17. Abi-Mansour P, Carberry PA, McCowan RJ et al (1998) Conversion efficacy and safety of repeated doses of ibutilide in patients with atrial flutter and atrial fibrillation. Study investigator. Am Heart J 136:632–642

    Article  PubMed  CAS  Google Scholar 

  18. Haft JL, Kosowsky BD, Lau SH et al (1967) Termination of atrial flutter by electrical pacing of the atrium. Am J Cardiol 20:229

    Article  Google Scholar 

  19. Feld GK, Fleck, Chen PS et al (1992) Radiofrequency catheter ablation for the treatment of human type I atrial flutter: identification of a critical zone in the reentrant circuit by endocardial mapping technique. Circulation 86:1233

    Article  PubMed  CAS  Google Scholar 

  20. Delia Bella P, Marenzi G, Tondo C et al (1989) Effects of disopyramide on cycle length, effective refractory period and excitable gap of atrial flutter, and relation to arrhythmia termination by overdrive pacing. Am J Cardiol 63:812–816

    Article  Google Scholar 

  21. Olshansky B, Okomura K, Hess PG et al (1988) Use of procainamide with rapid atrial pacing for successful conversion of atrial flutter to sinus rhythm. J Am Coll Cardiol 11:359–364

    Article  PubMed  CAS  Google Scholar 

  22. Doni F, Delia Bella P, Kheir A et al (1995) Atrial flutter termination by overdrive transesophageal pacing and the facilitating effect of oral propafenone. Am J Cardiol 76:1243–1246

    Article  PubMed  CAS  Google Scholar 

  23. D’Este D, Bertaglia M, Mantovan R et al (1997) Efficacy of intravenous propafenone in termination of atrial flutter by overdrive transesophageal pacing previously ineffective. Am J Cardiol 79:500–502

    Article  CAS  Google Scholar 

  24. Heldal M, Orning OM (1993) Effects of flecainide on termination of atrial flutter by rapid atrial pacing. Eur Heart J 14:421–424

    Article  PubMed  CAS  Google Scholar 

  25. Stambler BS, Wood MA, Ellenbogen KA (1996) Comparative efficacy of intravenous ibutilide versus procainamide for enhancing termination of atrial flutter by atrial overdrive pacing. Am J Cardiol 77:960–966

    Article  PubMed  CAS  Google Scholar 

  26. Vincenti A, Cirö A, De Ceglia S et al (2001) Predictors of failure of transoesophageal cardioversion of common atrial flutter. Europace 3:10–15

    Article  PubMed  CAS  Google Scholar 

  27. Chung DC, Kerr CR, Cooper J (1987) Termination of spontaneous atrial flutter by transesophageal pacing. Pacing Clin Electrophysiol 10:1147

    Article  PubMed  CAS  Google Scholar 

  28. Guarnerio M, Furlanello F, Del Greco M et al (1989) Transesophageal atrial pacing: a first choice technique in atrial flutter therapy. Am Heart J 117:1241

    Article  PubMed  CAS  Google Scholar 

  29. Kantharia BK, Mookherjee S (1995) Clinical utility and the predictors of outcome of overdrive atrial transesophageal atrial pacing in the treatment of the atrial flutter. Am J Cardiol 76:144–147

    Article  PubMed  CAS  Google Scholar 

  30. Raviele A, Bonso A, Gasparini G et al (1999) Ibutilide for cardioversion of atrial fibrillation: how effective and safe is it? In: Raviele A (ed) Cardiac arrhythmias. Springer, Milan, pp 186–190

    Google Scholar 

  31. Tai CT, Chen SA, Feng AN et al (1998) Electropharmacologic effects of class I and class III antiarrhythmia drugs on typical atrial flutter: insights into the mechanism of termination. Circulation 19:1935–1945

    Article  Google Scholar 

  32. Fera MS, Mazza A, Bettiol F et al (2001) Ibutilide versus transesophageal atrial pacing for atrial flutter treatment. Europace 2(suppl):A17

    Article  Google Scholar 

  33. Rossillo A, Bonso A Themistoclakis S et al (2002) Confronto tra studio elettrofisiologico transesofageo e ibutilide nella riconversione delle aritmie atriali sincronizzate. Ital Heart J 3(suppl): 173S

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Cardiovascular Department, Umberto I Hospital, Mestre-Venice, Italy

    A. Bonso, S. Themistoclakis, A. Rossillo & A. Raviele

Authors
  1. A. Bonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Themistoclakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Rossillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Raviele
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Divisione di Cardiologia, Ospedale Umberto I, Via Circonvallazione 50, I-30174, Venezia, Mestre, Italy

    Antonio Raviele MD

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Italia

About this paper

Cite this paper

Bonso, A., Themistoclakis, S., Rossillo, A., Raviele, A. (2004). Acute Termination of Atrial Flutter: Class III Drugs or Transesophageal Pacing?. In: Raviele, A. (eds) Cardiac Arrhythmias 2003. Springer, Milano. https://doi.org/10.1007/978-88-470-2137-2_34

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2137-2_34

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2177-8

  • Online ISBN: 978-88-470-2137-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation