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Sinus bradycardia and multiple episodes of sinus arrest following administration of ibutilide

Ibutilide is a Vaughan-Williams class III antiarrhythmic agent used for conversion of recent onset atrial flutter and fibrillation.1 We present the first case report of multiple sinus arrest episodes following administration of ibutilide in a patient with latent sinus node dysfunction.

A 79 year old woman with a history of hypertension, angina, and heart failure presented to the emergency department with exacerbation of heart failure. Medications before admission included metoprolol, digoxin, nitroglycerin, and aspirin.

On day 6, she complained of pleuritic pain radiating to the left arm and neck. Electrocardiography revealed atrial fibrillation with intermittent periods of atrial flutter. She became tachypnoeic with …