Efficacy and safety of dofetilide in patients with atrial fibrillation and atrial flutter

@article{Banchs2008EfficacyAS,
  title={Efficacy and safety of dofetilide in patients with atrial fibrillation and atrial flutter},
  author={Javier E. Banchs and Deborah L. Wolbrette and Soraya M. Samii and Erica D. Penny-Peterson and Parag P. Patel and Sallie K. Young and Mario D Gonzalez and Gerald V. Naccarelli},
  journal={Journal of Interventional Cardiac Electrophysiology},
  year={2008},
  volume={23},
  pages={111-115}
}
BackgroundDofetilide, an IKr blocker has been demonstrated to be effective in terminating persistent atrial fibrillation and flutter (AF/AFL), and in maintaining sinus rhythm after direct current cardioversion (CV). It is not known, however, whether pharmacological conversion with dofetilide predicts maintenance of sinus rhythm. In addition, there is limited information comparing the efficacy of dofetilide in persistent versus paroxysmal AF/AFL.Methods and ResultsEighty consecutive patients… Expand
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Highly Influential Citations
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Background Citations
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Clinical efficacy of dofetilide for the treatment of atrial tachyarrhythmias in adults with congenital heart disease.
TLDR
D should be considered a pharmacologic alternative when adult patients with CHD develop AT but needs close monitoring for potential ventricular pro-arrhythmia. Expand
Acute conversion of persistent atrial fibrillation during dofetilide loading does not predict long-term atrial fibrillation-free survival
TLDR
Acute pharmacologic conversion of persistent AF/AFl to sinus rhythm frequently occurs during dofetilide loading, but this does not predict long-term arrhythmia control, which was moderate at best. Expand
Frequency of toxicity with chemical conversion of atrial fibrillation with dofetilide.
TLDR
In patients hospitalized for initiation of dofetilide, CCV occurs in almost 50% and is associated with higher rates of pathologic QT prolongation and TdP compared with those who require ECV and patients with CCV may require closer monitoring for proarrhythmia. Expand
Magnitude of increase in QTc interval after initiation of dofetilide in patients with persistent atrial fibrillation is associated with increased rates of pharmacological cardioversion and long-term freedom from recurrent atrial fibrillation.
TLDR
The magnitude of QTc interval prolongation during dofetilide initiation is an independent predictor of successful PCV and long-term freedom from arrhythmia in patients with persistent AF. Expand
Discontinuation of Dofetilide From QT Prolongation and Ventricular Tachycardia in the Real World.
TLDR
The incidence of QT prolongation or VT that lead to discontinuation of dofetilide is remarkably higher in the real-world setting than in clinical trials. Expand
A Quarter of a Century Later: What is Dofetilide’s Clinical Role Today?
TLDR
Dofetilide is well tolerated and a good choice for patients with acceptable renal function and a normal QT interval, especially if atrioventricular nodal blockade needs to be avoided. Expand
New developments in atrial antiarrhythmic drug therapy
TLDR
The available data indicate that multiple ion channel blockers exhibiting potent inhibition of peak INa with relatively rapid unbinding kinetics, as well as inhibition of late INa and IKr, may be preferable for the management of AF when considering both safety and efficacy. Expand
Usefulness of pharmacologic conversion of atrial fibrillation during dofetilide loading without the need for electrical cardioversion to predict durable response to therapy.
TLDR
PC during in-hospital dofetilide loading is an important predictor of durable response even in long-standing persistent patients, which has important public health implications for choice of therapy. Expand
Novel pharmacological targets for the rhythm control management of atrial fibrillation.
TLDR
This review focuses on novel pharmacological targets for the rhythm control management of AF, suggesting atrial-selective sodium channel block can lead to safe and effective suppression of AF and that concurrent inhibition of potassium ion channels may potentiate this effect. Expand
Dofetilide induced torsade de pointes: mechanism, risk factors and management strategies.
TLDR
The underlying mechanism, risk factors and precautionary measures to avoid dofetilide induced QT prolongation and ventricular tachycardia/Tdp are discussed and a scheme for the management of QT prolongedation, ventricular arrhythmia and Tdp is suggested. Expand
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