Comparison Of Efficacy And Safety Of Ibutilide And Nifekalant In The Conversion Of Radiofrequency Ablation Of Persistent Atrial Fibrillation

Objective:Observe the parameters such as the success rate and the time required for resuscitation of patients with persistent atrial fibrillation during radiofrequency ablation using ibutilide and nifekalant and record whether adverse reactions such as sinus arrest,torsades de pointes occurred after administration,and evaluate the efficacy and safety of ibutilide and nifekalant in the conversion of radiofrequency ablation of persistent atrial fibrillation.Methods:77 patients with persistent atrial fibrillation who were treated with radiofrequency ablation at the Department of Cardiology,Second Hospital of Hebei Medical University from October 2018 to December 2019 were enrolled in this study.Atrial fibrillation was not completely terminated in all patients after adequate circumferential pulmonary vein isolation and linear ablation of the left atrium.And randomly divided into ibutilide and nifekalant groups,intravenous injection of nifekalant at 0.3 mg/kg was completed within 5 minutes,and 1 mg of ibutilide was completed within 10 minutes.The baseline data,the success rate of conversion,the time of conversion,and the corrected QT interval between conversions were compared between the two groups,and the occurrence of adverse reactions was observed,and the factors affecting the success rate of conversion were analyzed.Results : The success rate of conversion between the nifekalant group(61.5%,24/39)and the ibutilide group(55.3%,21/38)was similar.However,the converting time of the nifekalant group(7.04±1.58)min was shorter than that of the ibutilide group(10.63±4.39)min.The incidence of adverse reactions was similar between the two groups.Nifekalant and ibutilide significantly prolonged the average atrial cycle length and the QT interval,compared with that before injection.In the subgroups with successful and failed conversions of the two drugs,patients in the conversion group had a smaller left atrium scar areas ratio than non-conversion group.Conclusions:1.The conversion effect of nifekalant in radiofrequency ablation of persistent atrial fibrillation is better than that of ibutilide,which is mainly reflected in the short time required for conversion.And the incidence of adverse reactions was similar between the two groups.2.The left atrium scar areas ratio is an important factor for the success rate of conversion in the two groups of drugs.