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Dofetilide is safe and effective in preventing atrial fibrillation recurrences in patients accepted for catheter ablation
Europace, 10/15/09

Shamiss Y et al. – Dofetilide appears safe and effective in preventing AF in patients refractory to other AADs undergoing catheter ablation.

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Yana Shamiss, 10/15/09

This paper describes a cohort of 127 patients who were accepted for pulmonary vein ablation for atrial fibrillation (AF) after failing 2+/-1 antiarrhythmic drugs. These patients received dofetilide because they have failed other antiarrhythmic medications or as a bridge from amiodarone to ablation, since amiodarone was discontinued in all patients at least three months prior to ablation. Dofetilide was initiated during a hospital admission and the patients were closely monitored in accordance with the guidelines. Six patients had to stop the drug because of QT interval prolongation, none developed Torsade de Pointes on the titrated dose of the drug. Unlike 62% of the patients in this cohort who previously received amiodarone and had to stop it because of toxicity, dofetilide was well tolerated, only 6 patients had to stop it because of intolerance. Twenty two percent of the patients who were treated with dofetilide before ablation had no further AF. Of those who started the drug following an unsuccessful ablation, 45% had no further AF. Overall, dofetilide appeared to be safe, effective and well tolerated with only 9% of the patients unable to take this drug, used as a second or third line agent in this highly symptomatic and refractory group of patients, making it a sound alternative choice in rhythm management.

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