ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1623043
Predictive value of ibutilide response for postoperative recurrence following catheter ablation in persistent atrial fibrillation: a retrospective study
Provisionally accepted
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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This study investigated efficacy of intraoperative ibutilide administration for cardioversion of persistent atrial fibrillation (AF) during catheter ablation and evaluated predictive factors for postoperative AF recurrence.A retrospective analysis was conducted involving 111 patients with persistent AF who underwent radiofrequency catheter ablation. Patients who failed to restore sinus rhythm after ablation received intravenous ibutilide (1-2 mg). Patients achieving sinus rhythm post-ibutilide administration were categorized as responders, while nonresponders underwent electrical cardioversion. Clinical data were collected, and logistic regression was utilized to identify factors associated with ibutilide response and postoperative AF recurrence.Sinus rhythm was restored by ibutilide in 73 patients (65.7%). Non-response to ibutilide was independently associated with longer AF duration (OR=1.82), diabetes ellitus (OR=2.27), coronary artery disease (OR=2.56), increased ST2 (OR=1.08), larger left atrial diameter (LAD) (OR=1.25), elevated NT-proBNP (OR=1.01), and higher CHA2DS2-VASc scores (OR=1.96; all P<0.05). AF recurrence within 3 months post-ablation was independently predicted by intraoperative ibutilide nonresponse (OR=5.317), older age (OR=1.213), diabetes mellitus (OR=0.14), increased LAD (OR=1.211), elevated ST2 (OR=1.139), elevated hs-CRP (OR=1.276), and higher CHA2DS2-VASc scores (OR=2.736; all P<0.05).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.
Keywords: Atrial Fibrillation, Ibutilide, Catheter Ablation, Recurrence, Predictive factors, Pulmonary vein isolation
Received: 05 May 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Ma, Lai, Guo, Cai, Huang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jinxin Li, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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