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Dofetilide for atrial arrhythmias in congenital heart disease: a multicenter study

Ronald Wells1, Paul Khairy, Louise Harris

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.

Pacing and Clinical Electrophysiology : PACE
|August 21, 2009
PubMed

Insights

Dofetilide, a class III antiarrhythmic, shows promise for treating refractory atrial arrhythmias in adults with congenital heart disease (CHD). While initial adverse effects occurred, many patients achieved sustained arrhythmia control, suggesting dofetilide is a viable treatment option.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Limited data exists on dofetilide use in congenital heart disease (CHD) patients.
  • Atrial arrhythmias are common complications in adults with CHD.

Purpose of the Study:

  • To evaluate the safety and efficacy of dofetilide in adult patients with CHD and refractory atrial arrhythmias.

Main Methods:

  • Multicenter retrospective review of 20 adult CHD patients treated with dofetilide.
  • Analysis of adverse events, arrhythmia control, and long-term outcomes.

Main Results:

  • 15% of patients experienced adverse effects during in-hospital initiation (torsade de pointes, QTc prolongation).
  • 55% remained on dofetilide at follow-up, with 35% achieving complete arrhythmia resolution.
  • No torsade de pointes occurred after the initial in-hospital period.

Conclusions:

  • Dofetilide is a potentially effective treatment for atrial arrhythmias in adult CHD patients.
  • It can be a valuable adjunct to ablation and other pharmacological therapies.
Abstract

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