title: Short- and long-term clinical predictors of pharmacological cardioversion of persistent atrial fibrillation by dofetilide: A retrospective cohort study of 160 patients.
abstract: BACKGROUND
  Dofetilide is a class III antiarrhythmic prescribed to cardiovert persistent atrial fibrillation (AF) to sinus rhythm (SR).
  
  
  OBJECTIVE
  To determine the clinical predictors of cardioversion and readmission in persistent AF patients on dofetilide.
  
  
  METHODS
  We analyzed 160 patients with persistent AF who were started on dofetilide and followed for 1 year. We examined age, sex, race, hypertension, diabetes, smoking, dyslipidemia, CAD, left ventricular ejection fraction (LVEF), creatinine, BMI and concomitant use of calcium channel blockers (CCB), β-blockers in a multivariable logistic regression model. We also examined the same predictors in Cox regression model for AF-related readmission within 1 year of follow-up.
  
  
  RESULTS
  13.5% individuals did not convert to SR on dofetilide. 55.6% converted on the first dose and 83.1% converted by the fourth dose. In multivariable logistic models, dyslipidemia (OR: 2.4, CI: 1.12-5.16) and LVEF (OR: 3.83,CI: 1.37-10.8) were associated with failure to convert with the first dose. Female sex and LVEF also were associated with increased risk of failure to convert at all. Concomitant use of CCB associated with decreased risk of failure to convert to SR. In Cox proportional model, female sex, age <63 years and CAD were associated with increased AF readmission within 1 year.
  
  
  CONCLUSIONS
  Dyslipidemia and LVEF <40% were associated with failure to cardiovert after first dose, and female sex and LVEF 40% were related to failure to convert at all on dofetilide in persistent AF patients. After 1-year follow-up, female sex, known CAD, and age <63 years were associated with increased AF readmissions.
authors.affiliation: ACAP Cardiac Research Program, Al-Sabah Arrhythmia Institute, Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York.
authors.forename: Hafeez Ul
authors.identifier: http://orcid.org/0000-0002-9835-942X
authors.initials: HU
authors.lastname: Hassan Virk
authors.affiliation: Department of Cardiology, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Waqas T
authors.identifier: http://orcid.org/0000-0002-5189-4417
authors.initials: WT
authors.lastname: Qureshi
authors.affiliation: Department of Cardiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Nayani
authors.initials: N
authors.lastname: Makkar
authors.affiliation: ACAP Cardiac Research Program, Al-Sabah Arrhythmia Institute, Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bastawrose
authors.affiliation: ACAP Cardiac Research Program, Al-Sabah Arrhythmia Institute, Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York.
authors.forename: Nektarios
authors.initials: N
authors.lastname: Souvaliotis
authors.affiliation: ACAP Cardiac Research Program, Al-Sabah Arrhythmia Institute, Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York.
authors.forename: Joshua
authors.initials: J
authors.lastname: Aziz
authors.affiliation: ACAP Cardiac Research Program, Al-Sabah Arrhythmia Institute, Division of Cardiology, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York.
authors.forename: Emad
authors.initials: E
authors.lastname: Aziz
mesh_terms: D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends; D010627:Phenethylamines / Q000008:administration & dosage*; D026902:Potassium Channel Blockers / Q000008:administration & dosage; D012189:Retrospective Studies; D013449:Sulfonamides / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010627:Phenethylamines; D026902:Potassium Channel Blockers; D013449:Sulfonamides; C063533:dofetilide
keywords: Arrhythmia/all; management