Discontinuation of Dofetilide From QT Prolongation and Ventricular Tachycardia in the Real World

JACC. Clinical Electrophysiology
Vidhu AnandSelcuk Adabag

Abstract

The purpose of this study was to determine the incidence and correlates of QT prolongation or ventricular tachycardia (VT) resulting in discontinuation of dofetilide in a real-world setting. Dofetilide is a class III antiarrhythmic agent approved for achieving and maintaining sinus rhythm in patients with symptomatic atrial fibrillation. Because of a risk of QT prolongation and VT, patients starting dofetilide need to be hospitalized for 3 days to closely monitor telemetry and electrocardiography. In large clinical trials, <3% of patients had to discontinue dofetilide because of QT prolongation, but data from real-world experience are lacking. We examined 114 consecutive patients with atrial fibrillation who were hospitalized for starting dofetilide at the Minneapolis Veterans Affairs Health Care System from 2011 to 2014. The mean age of the patients was 64 ± 8 years. Dofetilide was discontinued in 22 (19%) patients because of QT prolongation (17%) or VT (2%). A total of 32 (28%) patients were taking other QT-prolonging drugs. Of these, 10 (31%) had to discontinue dofetilide versus 12 (15%) of the 82 patients who were not taking any other QT-prolonging drugs (p = 0.04). Patients who were taking concomitant QT-prolonging drugs w...Continue Reading

Citations

Jun 27, 2018·Journal of Cardiovascular Pharmacology and Therapeutics·Deborah L WolbretteGerald V Naccarelli
Jan 24, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Daniel A N MascarenhasBharat K Kantharia
Jul 23, 2021·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Daniel A N MascarenhasBharat K Kantharia

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