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

  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},
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… 

Clinical efficacy of dofetilide for the treatment of atrial tachyarrhythmias in adults with congenital heart disease.

D should be considered a pharmacologic alternative when adult patients with CHD develop AT but needs close monitoring for potential ventricular pro-arrhythmia.

Acute conversion of persistent atrial fibrillation during dofetilide loading does not predict long-term atrial fibrillation-free survival

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.

New developments in atrial antiarrhythmic drug therapy

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.

Novel pharmacological targets for the rhythm control management of atrial fibrillation.



Observations on the Safety and Effectiveness of Dofetilide in Patients With Paroxysmal Atrial Fibrillation and Normal Left Ventricular Function

Treatment with dofetilide in this study was successful in less than 1 in 5 patients, and serious proarrhythmias, the major limiting side effect, still occurred during long-term follow-up.

Efficacy and Safety of Oral Dofetilide in Converting to and Maintaining Sinus Rhythm in Patients With Chronic Atrial Fibrillation or Atrial Flutter: The Symptomatic Atrial Fibrillation Investigative Research on Dofetilide (SAFIRE-D) Study

Dofetilide, a new class III antiarrhythmic agent, is moderately effective in cardioverting AF or AFl to SR and significantly effective in maintaining SR for 1 year.

Antiarrhythmic actions of intravenous ibutilide compared with procainamide during human atrial flutter and fibrillation: electrophysiological determinants of enhanced conversion efficacy.

Enhanced conversion efficacy of ibutilide compared with procainamide in AFL is correlated with a relatively greater prolongation of atrial MAPD than atrial CL, and termination of AFL by ibutilides is characterized by oscillations in atrialCL and MAPD.

Acute Conversion of Persistent Atrial Fibrillation During Dofetilide Initiation

It is hypothesized that the acute pharmacological conversion rate of D is higher than previously reported if used in a healthier cohort of patients with persistent AF.

Dofetilide: a new class III antiarrhythmic agent

Oral dofetilide did not increase mortality in patients with a recent myocardial infarction or congestive heart failure, hence its importance as an alternative medication for the pharmacological conversion of atrial fibrillation and flutter, and maintenance of sinus rhythm after conversion in patients at high risk of sudden death.

Electrophysiologic Effects of the New Class III Antiarrhythmic Drug Dofetilide in an Experimental Canine Model of Pacing-induced Atrial Fibrillation

Dofetilide was highly effective in terminating and suppressing sustained atrial fibrillation induced by rapid atrial pacing in this canine model and appeared to be a progressive reduction and even tual extinction of re-entrant wavelets.

Inter-relationships of atrial fibrillation and atrial flutter mechanisms and clinical implications.

Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group.

In patients with congestive heart failure and reduced left ventricular function, dofetilide was effective in converting atrial fibrillation, preventing its recurrence, and reducing the risk of hospitalization for worsening heart failure.

Differential effects of dofetilide, amiodarone, and class Ic drugs on left and right atrial refractoriness and left atrial vulnerability in pigs

The shorter refractoriness of the left compared with the right atrium observed in pigs was associated with a high left atrial vulnerability for tachyarrhythmias, which was reduced only by amiodarone showing a balanced increase of left and right atrial ERP.