title: Dofetilide induced torsade de pointes: mechanism, risk factors and management strategies.
abstract: Dofetilide is an effective antiarrhythmic agent for conversion of atrial fibrillation and atrial flutter as well as maintenance of sinus rhythm in appropriately selected patients. However, as with other antiarrhythmic agents, proarrhythmia is a known adverse effect. The risk of dofetilide induced torsade de pointes (Tdp) is low when used with strict dosing criteria guided by renal function, QT interval and concomitant drug therapy. Benefit from dofetilide use must be individualized and weighed against the side effects and the role of other available treatment options. In this review, we discuss the underlying mechanism, risk factors and precautionary measures to avoid dofetilide induced QT prolongation and ventricular tachycardia/Tdp. We suggest a scheme for the management of QT prolongation, ventricular arrhythmia and Tdp as well.
authors: Division of Cardiology, New York Hospital Queens/Weill Medical College of Cornell University, Flushing, NY 11355, USA. Electronic address: jais.abhishek@gmail.com.
authors: Abhishek
authors: A
authors: Jaiswal
authors: Division of Cardiology, New York Hospital Queens/Weill Medical College of Cornell University, Flushing, NY 11355, USA.
authors: Seth
authors: S
authors: Goldbarg
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D004562:Electrocardiography; D006801:Humans; D010627:Phenethylamines / Q000009:adverse effects*; D012307:Risk Factors; D013449:Sulfonamides / Q000009:adverse effects*; D016171:Torsades de Pointes / Q000139:chemically induced*
chemical_list: D000889:Anti-Arrhythmia Agents; D010627:Phenethylamines; D013449:Sulfonamides; C063533:dofetilide
keywords: Atrial fibrillation; Dofetilide; Proarrhythmia; QT prolongation; Torsade de Pointes
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