Termination of acute wide QRS complex atrial fibrillation with ibutilide

Ibutilide is a Vaughan-Williams class III antiarrhythmic agent approved for chemical cardioversion of acute onset atrial fibrillation/flutter. Emergency physicians rarely use ibutilide despite its proven clinical value. We report a case of successful chemical cardioversion using ibutilide in a patient with atrial fibrillation and delayed ventricular depolarization (wide QRS complex). We recommend that ibutilide be considered for wider use in the emergency department and that further studies be conducted. (Am J Emerg Med 2000;18:462-464.