Cited by 215Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmias

Intravenous Dofetilide, a Class III Antiarrhythmic Agent, for the Termination of Sustained Atrial Fibrillation or Flutter

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Falk, Rodney H., Pollak, Arthur, Singh, Steven N., Friedrich, Tilman·1997·Journal of the American College of Cardiology

Abstract

OBJECTIVES: This study sought to determine the safety and efficacy of a single bolus of intravenous dofetilide, a pure class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter. BACKGROUND: Dofetilide is a highly selective blocker of the rapid component of the delayed rectifier current causing action potential prolongation. These effects, and preliminary clinical data, suggest that it may be effective in the treatment of atrial fibrillation and flutter. METHODS: Ninety-one patients with sustained atrial fibrillation (75 patients) or flutter (16 patients) were entered into a double-blind, randomized multicenter study of one of two doses of dofetilide (4 or 8 micrograms/kg body weight) or placebo. RESULTS: Dofetilide effectively terminated the arrhythmia in 31% of patients receiving 8 micrograms/kg, a statistically significant difference from those receiving 4 micrograms/kg (conversion rate 12.5%, p < 0.05) or placebo (no conversion, p < 0.01). Patients with atrial flutter had a greater response to dofetilide (54% conversion rate) than those with atrial fibrillation (14.5% conversion rate, p < 0.001). CONCLUSIONS: 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. This finding potentially represents an important advance in the pharmacologic termination of atrial flutter.

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Research works printed but not linked: 5

  1. Coplen SE, Antman FM, Berlin JM, Hewitt P, Chalmers TC. Efficacy and safety of quinidine therapy for the maintenance of sinus rhythm after cardioversion. Circulation 1990;82:1108 -16.
  2. Bashir V, Wong C, Nathan AW, Cobbe SM, Campbell RW, Rasmussen HS. Efficacy and safety of dofetilide, a new class III antiarrhythmic agent in recurrent ventricular tachycardia [abstract]. Br Heart J 1992;68:116.
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  5. Hohnloser SH, Arendts W, Quart B. Incidence, type and dose-dependence of proarrhythmic events during sotalol therapy in patients treated for sustained VT/VF [abstract]. PACE 1992;15:551.

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Authors
Falk, R. H., Pollak, A., Singh, S. N., & Friedrich, T.
Affiliations
Boston Medical Center (US)
Corresponding author
Falk, Rodney H.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1997-02
Volume
29
Issue
2
Pages
385-390
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2003632755
Cited by
215
References
30
Citations by year
2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 7 · 2015: 4 · 2013: 4 · 2012: 5
FWCI
15.58
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
dofetilide, intravenous administration, class III antiarrhythmic agents, sustained atrial fibrillation, atrial flutter, conversion to sinus rhythm, action potential prolongation
MeSH terms
Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Double-Blind Method, Hemodynamics, Humans, Phenethylamines, Sulfonamides, Treatment Outcome

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