Dofetilide in atrial fibrillation: A comprehensive review

Area of Science:

• Cardiology
• Pharmacology

Background:

• Atrial fibrillation (AF) is a prevalent cardiac arrhythmia with substantial global health impact.
• Managing AF involves complex strategies including rate/rhythm control, anticoagulation, and comorbidity management.

Purpose of the Study:

• To provide a comprehensive review of dofetilide, a Class III antiarrhythmic agent.
• To analyze dofetilide's pharmacology, clinical evidence, safety, and guideline recommendations.

Main Methods:

• Literature review of dofetilide's properties and clinical applications.
• Analysis of clinical trial data and safety profiles.
• Examination of guideline recommendations and special population considerations.

Main Results:

• Dofetilide selectively blocks the IKr potassium current, offering rhythm control with minimal negative inotropy.
• Its safety profile is favorable for patients with structural heart disease and left ventricular dysfunction.
• Concerns include torsades de pointes risk, requiring in-hospital initiation and strict monitoring.

Conclusions:

• Dofetilide is a valuable option for AF rhythm control, particularly in specific patient groups.
• Careful patient selection and monitoring are crucial for safe and effective use.
• Further research and real-world data are needed to optimize its application.