ibutilide / Generic mfg. - LARVOL DELTA

Association of common QT-prolonging medications with arrhythmic risk in patients with bundle branch block: A stratified cohort analysis in left bundle branch block vs. right bundle branch block phenotypes. (PubMed, Heart Lung) - "Common non-cardiac QT-prolonging medications were not associated with increased risk in patients with BBB, even with prolonged QTc. The divergence between composite and sensitivity results for amiodarone highlights the influence of confounding by indication. Medication alerts should incorporate stratification by drug class rather than QTc alone."

Journal • Cardiovascular • CNS Disorders • Congestive Heart Failure • Critical care • Heart Failure

Electrophysiological basis and pharmacological responses in short QT syndrome type 5: insights from iPSC-derived cardiomyocytes (ESC 2026) - "Although ibutilide prolonged APD by inhibiting IKr and Ito and activating late INa, it failed to restore ICa-L or reduce arrhythmic burden. hiPSC-derived cardiomyocytes from an SQTS5 patient carrying a CACNB2 mutation exhibit a vulnerable electrophysiological state and heightened sensitivity to proarrhythmic stimulation. APD prolongation alone is insufficient to restore electrical stability; instead, therapeutic benefit is more likely achieved by targeting the underlying pathogenic current deficit, providing a preclinical rationale for genotype- and mechanism-guided pharmacotherapy."

Cardiovascular

Human atrium-scaled in vitro modelling of atrial fibrillation: size-dependent arrhythmia dynamics and pharmacological responses (ESC 2026) - "Subsequent pharmacological testing included flecainide, ibutilide, or both. Upon 1 Hz electrical pacing all monolayers showed homogeneous wave propagation and similar wavelength between sizes. Our human atrium-sized in vitro modelling of AF enables mechanistic and translational research at a patient-relevant scale, demonstrating how size can critically influence arrhythmia dynamics and pharmacological responses."

Preclinical • Atrial Fibrillation • Cardiovascular

Rhythm vs. rate control for treatment of postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis of randomized controlled trials. (PubMed, Front Cardiovasc Med) - "An aggressive rhythm control strategy (ibutilide, procainamide, propafenone, or electric cardioversion) was associated with higher odds of in-hospital conversion to sinus rhythm [OR: 4.01 (95% CI: 1.30, 12.39)] and a higher risk of medication-related adverse events (hypotension, bradycardia, and syncope) [RR: 3.05 (95% CI: 1.05, 8.89)]. Among postcardiac surgery patients with new-onset atrial fibrillation, there was no evidence that a rhythm control treatment strategy resulted in better outcomes than a rate control strategy. https://www.crd.york.ac.uk/PROSPERO/view/CRD42019128559, identifier CRD42019128559."

Journal • Retrospective data • Review • Atrial Fibrillation • Cardiovascular • Hypotension

Neuronal safety of Kv11.1 blockers: Patch-clamp and in vitro evaluation with physiologically based pharmacokinetic (PBPK) modeling. (PubMed, Toxicol Rep) - "Here, we investigated Sotalol, Ibutilide, and Amiodarone, three clinically used Kv11.1 active compounds with distinct lipophilicity profiles, using an integrated strategy that combines whole-cell patch-clamp electrophysiology, cell viability assays, and physiologically based pharmacokinetic (PBPK) modeling in neuron-like SH-SY5Y cells, a human model widely used for neurotoxicity and ion-channel studies. Amiodarone's high lipid solubility drives persistent intracellular retention and cytotoxic morphology, while Ibutilide primarily exerts transient electrophysiological effects. This integrated PBPK-in-vitro framework provides a mechanistic basis for differentiating CNS risk among antiarrhythmics and highlights lipophilicity and broad ion channel activity as key determinants of neuronal safety."

Journal • PK/PD data • Preclinical

The present and future of antiarrhythmic drugs. (PubMed, JRSM Cardiovasc Dis) - "Flecainide, propafenone, and dronedarone have demonstrated their reliable efficacy and safety, even in patients with structural heart disease, which should allow clinicians to reduce their reliance on amiodarone. Previous concerns regarding the proarrhythmic risk of dofetilide and ibutilide are currently managed through careful patient selection and adequate QT interval monitoring. Novel targeted AADs are advancing through the development pipeline, of which etripamil and landiolol have already been approved. Other emerging drugs, such as SK channel blockers (AP30663 and AP31969), RyR2 blockers, CaMKII inhibitors, and TASK-1 blockers (doxapram), are aligned with the new paradigm of atrial fibrillation that focuses on triggers and re-entry...Developing concepts such as atrial cardiomyopathy allows clinicians to characterize substrate objectively, in order to assess disease severity and individualize antiarrhythmic treatment. The future of antiarrhythmic therapy will be..."

Journal • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Heart Failure

Individualized dynamic ablation strategy for persistent atrial fibrillation based on ibutilide response. (PubMed, Egypt Heart J) - "The use of ibutilide may help identify "PVI‑sensitive" atrial fibrillation, reducing the extent of ablation without compromising efficacy.Female sex, LA enlargement, prolonged AF duration, and requiring DC/failing to terminate acutely predict recurrence."

Journal • Atrial Fibrillation • Cardiovascular

Ibutilide: what's clinically proven, what's being investigated? (PubMed, Indian Pacing Electrophysiol J) - "Ibutilide fumarate is a methanesulfonamide derivative that is structurally similar to sotalol without the β-adrenoreceptor blocking activity...As compared to ibutilide, coadministration with propafenone has a significantly higher success rate of for AF termination...It is safe drug to use for cardioversion in patients on chronic amiodarone therapy. The main side effect of dofetilide is torsade de pointes occurs in 4% patients and monomorphic ventricular tachycardia in 4.9% patients...Conversion rate with ibutilide infusion is only 30% in the presence of an enlarged left atrium (> 5 cm) and 37.7% in the presence of mitral valve disease (MVD), whereas the conversion rate was 82.5% in the absence of MVD and 85% in the absence of both enlarged left atrium and mitral valve disease (p = <0.001). Ibutilide can be used effectively in patients who are not a candidate for direct current cardioversion or who chose not to undergo electric cardioversion."

Journal • Review • Atrial Fibrillation • Cardiovascular • Ventricular Tachycardia

Antiarrhythmic Drug Therapy for Acute Management of Atrial Fibrillation and Atrial Flutter. (PubMed, Card Electrophysiol Clin) - "It details the efficacy, indications, and safety profiles of commonly used agents, including beta-blockers, calcium channel blockers, and antiarrhythmic drugs such as amiodarone, ibutilide, dofetilide, and flecainide. The article highlights patient-specific considerations, emerging therapies, and the need for safer, faster acting drugs as atrial fibrillation prevalence rises. Both traditional and novel approaches are discussed to guide evidence-based clinical decision-making in acute settings."

Journal • Review • Atrial Fibrillation • Cardiovascular

Detecting Local Myocardial Spatiotemporal Repolarization Gradients With Clinical Mapping Arrays. (PubMed, Circ Arrhythm Electrophysiol) - "Repolarization changes were created using global infusion of ibutilide or pinacidil, or topical application of lidocaine. Although ARI only correlates with uniformly distributed changes in repolarization in the entire myocardium, RepolLoc also provided accurate regional gradient assessment and duration alternans of repolarization. These findings suggest ARI has significant far-field contamination and RepolLoc may provide a better clinical mapping tool for spatiotemporal repolarization gradient mapping."

Journal

POLYCYTHEMIA VERA AS A PRECIPITATING FACTOR FOR ATRIAL FIBRILLATION AND NEW-ONSET HEART FAILURE IN A YOUNG PATIENT: A CASE REPORT (CHEST 2025) - "The patient was started on intravenous diltiazem, heparin for anticoagulation, diuretics, and ceftriaxone and doxycycline...A TEE was performed to rule out thrombus in the left atrium, and chemical conversion was achieved using IV ibutilide...Following multidisciplinary consultation, the patient was discharged on GDMT and warfarin... PV is a serious hematologic disorder with potential cardiovascular manifestations. Utilizing appropriate diagnostic measures, including history, laboratory findings, and imaging, is crucial in identifying PV as an underlying cause AF and HFrEF. Persistent erythrocytosis and unexplained thrombosis should prompt further evaluation."

Case report • Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Cough • Fatigue • Heart Failure • Hematological Disorders • Infectious Disease • Ischemic stroke • Myocardial Ischemia • Pneumonia • Polycythemia Vera • Pulmonary Disease • Respiratory Diseases • Thrombosis • JAK2

Predictive value of ibutilide response for postoperative recurrence following catheter ablation in persistent atrial fibrillation: a retrospective study. (PubMed, Front Cardiovasc Med) - "Intraoperative ibutilide responsiveness significantly predicts postoperative AF recurrence in patients undergoing catheter ablation for persistent AF. Assessing ibutilide response may enhance risk stratification and guide personalized treatment strategies."

Journal • Retrospective data • Atrial Fibrillation • Cardiovascular • Coronary Artery Disease • Diabetes • Metabolic Disorders

Reducing the Risk of Drug-Induced QT Interval Lengthening in Women (clinicaltrials.gov) - P4 | N=27 | Completed | Sponsor: Indiana University | N=16 ➔ 27

Enrollment change • Cardiovascular

Novel Approaches for Minimizing Drug-Induced QT Interval Lengthening (clinicaltrials.gov) - P4 | N=73 | Completed | Sponsor: Indiana University | Active, not recruiting ➔ Completed | Trial completion date: Oct 2025 ➔ Apr 2025

Trial completion • Trial completion date

Novel Approaches for Minimizing Drug-Induced QT Interval Lengthening (clinicaltrials.gov) - P4 | N=83 | Active, not recruiting | Sponsor: Indiana University | Trial primary completion date: Oct 2025 ➔ Apr 2025

Trial primary completion date

Novel Approaches for Minimizing Drug-Induced QT Interval Lengthening (clinicaltrials.gov) - P4 | N=83 | Active, not recruiting | Sponsor: Indiana University | Recruiting ➔ Active, not recruiting

Enrollment closed

A SHORT-SHORT CIRCUIT — A CASE OF ATYPICAL AVNRT WITH A LOWER COMMON PATHWAY BLOCK - Hamid Shirwany (ACC 2025) - "Afterwards, she required inotropes for cardiogenic shock and developed recurrent SVT resistant to adenosine, amiodarone, and ibutilide.Decision-making: Repeat EPS demonstrated inducible SVT following AH jump with Wenckebach conduction of the AH interval and droped His without a change in the TCL. This case highlights a rare presentation of AVNRT and the importance of recognizing tachycardia-medicated cardiomyopathy."

Clinical • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Ventricular Tachycardia

Effect of the Membrane Environment on Pharmacologic Inhibition of hERG K+ Channel Activity. (PubMed, JACC Clin Electrophysiol) - "These results support the idea that the lipid environment of the plasma membrane plays a role in the ability of certain drugs to inhibit hERG channel activity. Differences in membrane cholesterol content may affect the ability of some hERG channel blockers to produce arrhythmogenic behavior."

Journal • Cardiovascular • Ventricular Tachycardia

Clinical Efficacy and Safety of Ibutilide in Cardioversion of Atrial Fibrillation or Flutter in Indian Patients: A Multicenter Study. (PubMed, Indian J Crit Care Med) - "Dewan B, Navale S, Shinde S, Chaudhary J. Clinical Efficacy and Safety of Ibutilide in Cardioversion of Atrial Fibrillation or Flutter in Indian Patients: A Multicenter Study. Indian J Crit Care Med 2025;29(1):45-51."

Clinical • Journal • Atrial Fibrillation • Cardiovascular • Pain • Ventricular Tachycardia

Novel Approaches for Minimizing Drug-Induced QT Interval Lengthening (clinicaltrials.gov) - P4 | N=83 | Recruiting | Sponsor: Indiana University | Trial completion date: Dec 2024 ➔ Oct 2025 | Trial primary completion date: Dec 2024 ➔ Oct 2025

Trial completion date • Trial primary completion date

Chemical Cardioversion of Atrial Arrhythmias with Ibutilide in Children and Adults with Congenital Heart Disease. (PubMed, Pediatr Cardiol) - "Presentation in atrial flutter (P = 0.08) and male gender (0.07) showed a trend towards significance. Adverse effects were reported after 8 ibutilide administrations (7.6%, n = 6/8 [75%] female)."

Journal • Cardiovascular • Heart Failure • Pediatrics • Ventricular Tachycardia

Mechanisms of Chemical Atrial Defibrillation by Flecainide and Ibutilide. (PubMed, JACC Clin Electrophysiol) - "We predict the drug concentrations that promote efficacy of flecainide and ibutilide used in combination for atrial chemical defibrillation. We also predict the potential safety pharmacology impact of this drug combination on ventricular electrophysiology."

Journal • Cardiovascular

Drug-induced increase in dispersion of ventricular repolarization in patients with heart failure with preserved ejection fraction. (PubMed, Int J Cardiol) - "HFpEF is associated with enhanced response to drug-induced increases in dispersion of repolarization."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Effect of Obesity on the Use of Antiarrhythmics in Adults With Atrial Fibrillation: A Narrative Review. (PubMed, Clin Cardiol) - "Antiarrhythmics are not uniformly affected by obesity. This observation is based on heterogeneous studies of participants with an average BMI and poorly controlled confounding factors such as multimorbidity, concomitant medications, varying routes of administration, and assessment of obesity. Controlled trials with stratification at the time of recruitment for obesity are necessary to determine the significance of these findings."

Journal • Review • Atrial Fibrillation • Cardiovascular • Genetic Disorders • Obesity

External electrical and pharmacological cardioversion for atrial fibrillation, atrial flutter or atrial tachycardias: a network meta-analysis. (PubMed, Cochrane Database Syst Rev) - "Despite the low quality of evidence, this systematic review provides important information on electrical and pharmacological strategies to help patients and physicians deal with AF and atrial flutter. In the assessment of the patient comorbidity profile, antiarrhythmic drug onset of action and side effect profile versus the need for a physician with experience in sedation, or anaesthetics support for electrical cardioversion are key aspects when choosing the cardioversion method."

Clinical • Journal • Retrospective data • Review • Anesthesia • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure