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Dofetilide: a new drug to control cardiac arrhythmia
Hanne Elming1, Bente Brendorp, Ole Dyg Pedersen
1Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. he@heart.dk
Insights
Atrial fibrillation (AF) is a common heart rhythm disorder. Dofetilide offers an effective and safe treatment option for AF when dosed carefully, as recommended by guidelines.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, posing significant mortality and morbidity risks.
- AF prevalence increases with age and is linked to hypertension, heart failure, and other cardiovascular diseases.
- Existing antiarrhythmic drugs often present safety concerns due to pro-arrhythmic potential.
Purpose of the Study:
- To evaluate the efficacy and safety of dofetilide, a Vaughan Williams class III antiarrhythmic agent, for treating atrial fibrillation.
- To assess dofetilide's performance in high-risk patient populations.
Main Methods:
- Dofetilide's development included dedicated safety studies in high-risk individuals.
- Implementation of an elaborate dosing procedure for dofetilide administration.
Main Results:
- Dofetilide demonstrates effectiveness and safety in treating atrial fibrillation.
- The drug's safety profile was specifically investigated in high-risk patient groups.
Conclusions:
- Dofetilide is a recommended treatment for AF, alongside amiodarone and beta-blockers.
- Effective and safe use of dofetilide is contingent upon a meticulous dosing protocol.
Abstract:
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Mortality, and especially morbidity caused by AF, are major and growing health problems in the western world. AF is strongly associated with arterial hypertension, congestive heart failure, valvular heart disease, ischaemic heart disease, and with prevalence increasing with age. A variety of drugs have been used to terminate or prevent AF but, as many antiarrhythmic agents have the potential life-threatening pro-arrhythmia, safety problems remain. Dofetilide (Tikosyn, Pfizer), a new Vaughan Williams class III antiarrhythmic agent, has been developed and approved for the treatment of AF. In contrast to most antiarrhythmic agents, the development programme included two safety studies in high-risk patients. Dofetilide is effective and safe when an elaborate procedure for dosing is implemented. Along with amiodarone and betablockers, dofetilide is the only antiarrhythmic drug, which is recommended by guidelines for the treatment of AF in a wide range of patients.