Ibutilide may be reasonable in the acute setting to restore sinus rhythm in hemodynamically stable patients with focal AT.205,206 See Online Data Supplement 6. The effectiveness of ibutilide for treatment of focal AT is unclear. In 1 study, intravenous ibutilide terminated AT of single atrial morphology in 19 of 39 patients (38.8%), but the proportions of patients with focal AT and macroreentrant AT were not differentiated in this study cohort.206 Recommendations for Acute Treatment of Suspected Focal Atrial Tachycardia (Continued) COR LOE Recommendations Recommendations for Ongoing Management of Suspected Focal Atrial Tachycardia COR LOE Recommendations I B-NR 1. Catheter ablation is recommended in patients with symptomatic focal AT as an alternative to pharmacological therapy.122 126,188,191 196,206 See Online Data Supplement 6. A large number of nonrandomized cohort studies on focal AT ablation have accumulated in the past 2 decades. In a 2012 ablation registry provided by 74 voluntary medical centers in Spain, AT was found in 333 of 11042 of the ablation procedures performed.122 In experienced centers, when the AT can be induced in the laboratory, acute success rates above 90% to 95% have consistently been reported, with a complication rate of <1% to 2%.122,123,125,196 See Table 8 for a summary of ablation efficacy, complications, and rate of recurrence. Although uncommon, focal AT-mediated cardiomyopathy should be recognized in patients presenting with heart failure, reduced ventricular function, and persistent tachycardia. In a case control study of patients with AT, 10% of patients had evidence of cardiomyopathy.125 The tachycardia in patients with cardiomyopathy was incessant and slower than in the patients without cardiomyopathy (cycle lengths 502 ms and 402 ms, respectively). Normal ejection fraction was restored in 97% of patients after successful ablation.188 IIa C-LD 1. 