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

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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

DOI 10.1016/s0735-1097(96)00506-2

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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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Authors: Falk, R. H., Pollak, A., Singh, S. N., & Friedrich, T.
Affiliations: Boston Medical Center (US)
Corresponding author: Falk, Rodney H.
ORCID: Falk, Rodney H.
Pollak, Arthur
Singh, Steven N.
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)
DOI: 10.1016/s0735-1097(96)00506-2
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: hybrid
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor, 1208 d)
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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Intravenous Dofetilide, a Class III Antiarrhythmic Agent, for the Termination of Sustained Atrial Fibrillation or Flutter

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