Dofetilide is safe and effective in preventing atrial fibrillation recurrences in patients accepted for catheter ablation.
OBJECTIVE
The aim of this study was to assess the safety and efficacy of dofetilide among patients refractory to other anti-arrhythmic drugs (AADs) and accepted for atrial fibrillation (AF) ablation.


RESULTS
One hundred and twenty-seven of 454 patients (69% male, 58% paroxysmal, age 60 +/- 10 years, AF duration 8 +/- 7 years) scheduled for AF ablation between February 2004 and May 2008 were treated with dofetilide. Patients had failed 1.9 +/- 1.1 AADs. Anti-arrhythmic drugs were stopped five half-lives before ablation and 3 months for amiodarone. Patients were followed for 15 +/- 7 months with routine and symptom-driven monitoring. Success was defined as no further AF and partial success as a 50% reduction in frequency/duration of AF episodes. Thirty-six patients started dofetilide 158 +/- 167 days before ablation: 9 had no improvement, 16 experienced partial success, 8 had no further AF, and 2 improved enough to forgo ablation. Seventy-one patients started dofetilide immediately following ablation, of which 14 had no improvement, 22 experienced partial success, and 32 had no further AF. Twenty patients started dofetilide 119 +/- 153 days post-ablation, of which four had no improvement, seven experienced partial success, and nine had no further AF. Six patients discontinued dofetilide during initiation for QT prolongation.


CONCLUSIONS
Dofetilide appears safe and effective in preventing AF in patients refractory to other AADs undergoing catheter ablation.
Shamiss
Yana
Y
Southlake Regional Health Center, Newmarket, ON, Canada.
Khaykin
Yaariv
Y
Oosthuizen
Richard
R
Tunney
Denise
D
Sarak
Bradley
B
Beardsall
Marianne
M
Seabrook
Catherine
C
Frost
Linda
L
Wulffhart
Zaev
Z
Tsang
Bernice
B
Verma
Atul
A
D001281:Atrial Fibrillation / Q000517:prevention & control* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010627:Phenethylamines / Q000009:adverse effects / Q000627:therapeutic use*; D011292:Premedication / Q000379:methods*; D055502:Secondary Prevention; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D010627:Phenethylamines; D013449:Sulfonamides; C063533:dofetilide