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
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
...
1
2
3
...

References

SHOWING 1-10 OF 25 REFERENCES
Efficacy of Dofetilide in the Treatment of Atrial Fibrillation-Flutter in Patients With Reduced Left Ventricular Function: A Danish Investigations of Arrhythmia and Mortality ON Dofetilide (DIAMOND) Substudy
TLDR
Dofetilide is safe and increases the probability of obtaining and maintaining sinus rhythm in patients with structural heart disease, and suggests that restoration of sinus Rhythm is associated with improved survival. Expand
Observations on the Safety and Effectiveness of Dofetilide in Patients With Paroxysmal Atrial Fibrillation and Normal Left Ventricular Function
TLDR
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. Expand
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
TLDR
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. Expand
Antiarrhythmic actions of intravenous ibutilide compared with procainamide during human atrial flutter and fibrillation: electrophysiological determinants of enhanced conversion efficacy.
TLDR
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. Expand
Acute Conversion of Persistent Atrial Fibrillation During Dofetilide Initiation
TLDR
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. Expand
Dofetilide: a new class III antiarrhythmic agent
TLDR
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. Expand
Intravenous dofetilide, a class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter. Intravenous Dofetilide Investigators.
TLDR
Intravenous dofetilide can convert sustained atrial fibrillation or flutter to sinus rhythm, however, its efficacy is greater in flutter--a response that contrasts with the poorer response seen with class I agents. Expand
Electrophysiologic Effects of the New Class III Antiarrhythmic Drug Dofetilide in an Experimental Canine Model of Pacing-induced Atrial Fibrillation
TLDR
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. Expand
Inter-relationships of atrial fibrillation and atrial flutter mechanisms and clinical implications.
TLDR
There are probably several mechanisms of AF, 1 of which is due to a very rapid AFL causing fibrillatory conduction, all of which have important clinical implications. Expand
Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group.
TLDR
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. Expand
...
1
2
3
...