Related Experiment Video

Updated: Jul 25, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

A Quarter of a Century Later: What is Dofetilide's Clinical Role Today?

Deborah L Wolbrette1, Sarah Hussain1, Ilir Maraj1

  • 11 Heart and Vascular Institute, Penn State University College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA, USA.

Journal of Cardiovascular Pharmacology and Therapeutics
|June 27, 2018
PubMed

Insights

Dofetilide effectively converts atrial fibrillation and flutter in real-world use, showing higher rates than clinical trials. It is safe and well-tolerated when initiated under hospital monitoring, especially for patients with normal renal function and QT intervals.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Dofetilide is a Class III antiarrhythmic agent.
  • Approved for persistent atrial fibrillation/flutter and sinus rhythm maintenance.
  • Previous trials indicated neutral mortality in post-MI and heart failure patients.

Purpose of the Study:

  • Review postmarket data on dofetilide's real-world efficacy and safety.
  • Evaluate off-label use in various arrhythmias.
  • Compare real-world conversion rates to clinical trial data.

Main Methods:

  • Review of postmarket data.
  • Analysis of real-world efficacy and safety in diverse patient populations.
  • Assessment of off-label use and conversion rates.

Main Results:

  • Real-world acute conversion rates for atrial fibrillation and flutter exceed clinical trial findings.
  • Dofetilide demonstrates success in off-label use for paroxysmal atrial fibrillation/flutter, atrial tachycardia, and ventricular tachycardia.
  • Acceptable safety profile when initiated with hospital monitoring and appropriate dosing based on creatinine clearance.

Conclusions:

  • Dofetilide is well-tolerated and effective for patients with adequate renal function and normal QT intervals.
  • It is a suitable option when avoiding atrioventricular nodal blockade is desired.
  • Real-world data supports higher efficacy than previously reported in clinical trials.

Keywords:
atrial fibrillationatrial flutterdofetilide

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