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Dofetilide: Electrophysiologic Effect, Efficacy, and Safety in Patients with Cardiac Arrhythmias

Fatemah Shenasa1, Mohammad Shenasa1

  • 1Heart and Rhythm Medical Group, Department of Cardiovascular Services, O'Connor Hospital, 105 North Bascom Avenue, San Jose, CA 95128, USA.

Cardiac Electrophysiology Clinics
|June 5, 2016
PubMed

Insights

Dofetilide, a Class III antiarrhythmic, effectively treats arrhythmias by blocking potassium current (IKr). While safe for heart failure patients, it carries a risk of ventricular arrhythmias and requires dose adjustment for kidney impairment.

Area of Science:

  • Pharmacology
  • Cardiology

Background:

  • Dofetilide is a Class III antiarrhythmic drug.
  • It selectively blocks the rapid component of the delayed rectifier potassium current (IKr).

Purpose of the Study:

  • To summarize the safety and efficacy of dofetilide.
  • To highlight key considerations for its clinical use.

Main Methods:

  • Review of existing clinical data and pharmacological properties of dofetilide.

Main Results:

  • Dofetilide demonstrates safety in patients post-myocardial infarction and with heart failure.
  • A significant adverse effect is the proarrhythmic risk, particularly torsades de pointes.
  • Renal excretion is approximately 80%, necessitating dose adjustment in renal impairment.
  • Administration is contraindicated if QTc exceeds 500 ms.

Conclusions:

  • Dofetilide is a valuable antiarrhythmic agent with specific safety considerations.
  • Careful patient selection and monitoring are crucial for managing proarrhythmic risks and renal function.
  • Strict adherence to QTc interval guidelines is essential.

Keywords:
Atrial fibrillationAtrial flutterCardiac arrhythmiasDofetilideHeart failureProarrhythmiasTorsades de pointes

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