Late dofetilide-associated life-threatening proarrhythmia.

Area of Science:

• Cardiology
• Pharmacology
• Medical Devices

Background:

• Atrial fibrillation management often involves antiarrhythmic drugs and implantable cardioverter defibrillators (ICDs).
• Patient-activated ICDs allow for termination of tachyarrhythmias.
• Dofetilide is an antiarrhythmic agent used for atrial fibrillation.

Observation:

• A 62-year-old male patient with an ICD for atrial fibrillation termination was treated with dofetilide.
• Six months post-initiation of dofetilide therapy, the patient experienced ventricular tachyarrhythmias.
• The patient's ICD was activated, leading to ventricular fibrillation.

Findings:

• The patient experienced dofetilide-associated ventricular tachyarrhythmias.
• ICD therapy resulted in ventricular fibrillation.
• A potential drug-device interaction between dofetilide and the ICD was observed.

Implications:

• This case underscores the critical need for careful monitoring of patients on antiarrhythmic drugs with ICDs.
• Potential proarrhythmic effects of dofetilide in conjunction with ICD therapy require further investigation.
• Clinicians should be vigilant about drug-device interactions when managing complex cardiac arrhythmias.