Cited by 496Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac pacing and defibrillation studies

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

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Pedersen, Ole D., Bagger, Henning, Keller, Niels, Marchant, Bradley, Køber, Lars, Torp-Pedersen, Christian·2001·Circulation

Abstract

BACKGROUND: In patients with left ventricular dysfunction, atrial fibrillation and flutter (AF and AFl, respectively) are common arrhythmias associated with increased morbidity and mortality. The present study investigated the potential of dofetilide in AF-AFl patients with left ventricular dysfunction to restore and maintain sinus rhythm, which might reduce mortality and hospitalizations. METHODS AND RESULTS: In the Danish Investigations of Arrhythmia and Mortality ON Dofetilide (DIAMOND) studies, 506 patients were in AF-AFl at baseline. Over the course of study, cardioversion occurred in 148 (59%) dofetilide- and 86 (34%) placebo-treated patients. In these patients, the probability of maintaining sinus rhythm for 1 year was 79% with dofetilide versus 42% with placebo (P<0.001). Dofetilide had no effect on all-cause mortality, but restoration and maintenance of sinus rhythm was associated with significant reduction in mortality (risk ratio [RR], 0.44; 95% CI, 0.30 to 0.64; P<0.0001). In addition, dofetilide therapy was associated with a significantly lower risk ratio versus placebo for either all-cause (RR, 0.70; 95% CI, 0.56 to 0.89; P</=0.005) or congestive heart failure (RR, 0.69; 95% CI, 0.51 to 0.93; P</=0.02) rehospitalization. CONCLUSIONS: Dofetilide is safe and increases the probability of obtaining and maintaining sinus rhythm in patients with structural heart disease. The present study suggests that restoration of sinus rhythm is associated with improved survival.

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Authors
Pedersen, O. D., Bagger, H., Keller, N., Marchant, B., Køber, L., & Torp-Pedersen, C.
Affiliations
Pfizer (United Kingdom) (GB)
Venue
Circulation
Published
2001-07-17
Volume
104
Issue
3
Pages
292-296
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2126749500
Cited by
496
References
23
Citations by year
2026: 7 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 13 · 2021: 11 · 2020: 14 · 2019: 15 · 2018: 14 · 2017: 18 · 2016: 21 · 2015: 24 · 2014: 24 · 2013: 35 · 2012: 23
FWCI
16.19
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
Pfizer
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 pacing and defibrillation studies
Keywords
dofetilide, atrial fibrillation, atrial flutter, left ventricular dysfunction, sinus rhythm restoration, sinus rhythm maintenance, cardioversion, all-cause mortality, structural heart disease
MeSH terms
Administration, Oral, Adult, Aged, Aged, 80 and over, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Chronic Disease, Denmark, Double-Blind Method, Female, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Myocardial Infarction, Phenethylamines, Sulfonamides, Survival Rate, Odds Ratio, Treatment Outcome, Ventricular Dysfunction, Left

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