Dofetilide: a new pure class III antiarrhythmic agent

Area of Science:

• Pharmacology
• Cardiology
• Electrophysiology

Background:

• Existing antiarrhythmic agents for atrial fibrillation and flutter have drawbacks.
• Novel pharmacologic agents are needed for treating these arrhythmias.

Purpose of the Study:

• To review the efficacy and safety of dofetilide, a pure class III antiarrhythmic agent.
• To evaluate dofetilide's role in managing supraventricular arrhythmias.

Main Methods:

• Review of published data on dofetilide, including full studies and abstracts.
• Focus on properties related to efficacy in supraventricular arrhythmias.

Main Results:

• Dofetilide exhibits pure class III properties by blocking the delayed rectifier potassium current.
• It is effective for atrial fibrillation and flutter with no negative inotropic effect.
• While torsades de pointes occurred in 2% of patients with impaired ventricular function, no increased mortality was observed.

Conclusions:

• Dofetilide's electrophysiologic profile suggests safety and clinical utility.
• It is effective for terminating and preventing atrial fibrillation or flutter.
• The drug is potentially useful even in patients with impaired ventricular function.