PMID: 11326815May 1, 2001Paper

Dofetilide (Tikosyn): a new drug to control atrial fibrillation

Cleveland Clinic Journal of Medicine
W I Saliba

Abstract

Dofetilide, a new class III antiarrhythmic agent, selectively blocks a specific cardiac potassium channel, IKr, increasing the effective refractory period of the myocyte and thereby terminating reentrant arrhythmias. Given orally, it appears to effectively convert atrial fibrillation and atrial flutter to sinus rhythm and maintain sinus rhythm after conversion in appropriately selected patients. This paper reviews the pharmacology of dofetilide, the evidence of its effectiveness, and the appropriate precautions in using it. Dofetilide is generally well tolerated but like other class III drugs can cause torsades de pointes. The risk is dose-dependent and can be minimized by adjusting the dosage according to creatinine clearance and QT interval, by excluding patients with known risk factors for long QT syndrome and torsades de pointes, and by starting treatment in an inpatient monitored setting for the first 3 days. Unlike other antiarrhythmic agents, oral dofetilide did not increase the mortality rate in clinical studies in postmyocardial infarction patients or those with congestive heart failure at high risk for sudden cardiac death. Concomitant use of drugs that increase the plasma level of dofetilide is contraindicated; these...Continue Reading

Citations

Nov 8, 2002·Diabetic Medicine : a Journal of the British Diabetic Association·M LechleitnerA Dzien
Jan 15, 2008·International Journal of Cardiology·A John Camm
Aug 18, 2005·Pacing and Clinical Electrophysiology : PACE·James A Reiffel
Jun 5, 2016·Cardiac Electrophysiology Clinics·Fatemah Shenasa, Mohammad Shenasa
Sep 21, 2002·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Bente BrendorpLars Køber
Apr 5, 2021·JACC. Clinical Electrophysiology·Ghanshyam ShanthaHakan Oral

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