Efficacy of Dofetilide in the Treatment of Atrial Fibrillation-Flutter in Patients With Reduced Left Ventricular Function

Pedersen, Ole Dyg; Bagger, Henning; Keller, Niels; Marchant, Bradley; Køber, Lars; Torp‐Pedersen, Christian

doi:10.1161/01.cir.104.3.292

Cited by 435 publications

(75 citation statements)

References 21 publications

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“…These findings are consistent with those of the DIAMOND Study, in which the presence of SR throughout that trial was associated with improved survival. 4 Because of the retrospective, nonrandomized nature of the analyses, however, neither the DIA-MOND Study nor ours can distinguish whether SR is an important determinant of survival or a marker for other factors associated with survival that were not recorded, determined, or included in the survival model.…”

Section: Discussionmentioning

confidence: 87%

“…3 In a series of trials assessing the efficacy and safety of dofetilide to treat AF, the Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) studies showed that patients who had SR either with or without AAD therapy had a superior prognosis compared with patients with continued AF. 4 Thus, the possibility arose that the presence or absence of SR itself, rather than treatment strategy, is responsible for outcome.…”

mentioning

confidence: 99%

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Relationships Between Sinus Rhythm, Treatment, and Survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study

Corley¹,

Epstein²,

DiMarco³

et al. 2004

Circulation

1,032

168

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The AFFIRM Investigators* Background-The AFFIRM Study showed that treatment of patients with atrial fibrillation and a high risk for stroke or death with a rhythm-control strategy offered no survival advantage over a rate-control strategy in an intention-to-treat analysis. This article reports an "on-treatment" analysis of the relationship of survival to cardiac rhythm and treatment as they changed over time. Methods and Results-Modeling techniques were used to determine the relationships among survival, baseline clinical variables, and time-dependent variables. The following baseline variables were significantly associated with an increased risk of death: increasing age, coronary artery disease, congestive heart failure, diabetes, stroke or transient ischemic attack, smoking, left ventricular dysfunction, and mitral regurgitation. Among the time-dependent variables, the presence of sinus rhythm (SR) was associated with a lower risk of death, as was warfarin use. Antiarrhythmic drugs (AADs) were associated with increased mortality only after adjustment for the presence of SR. Consistent with the original intention-to-treat analysis, AADs were no longer associated with mortality when SR was removed from the model. Conclusions-Warfarin

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Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 99%

Relationships Between Sinus Rhythm, Treatment, and Survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study

Corley¹,

Epstein²,

DiMarco³

et al. 2004

Circulation

1,032

168

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“…33,34 Because of the risk of torsade de points within first three days, therapy with dofetilide requires in-hospital initiation with close monitoring of the QT interval and dosage adjustments in patients with impaired renal function.…”

Section: 12mentioning

confidence: 99%

“…33, 34 Zbog rizika od razvoja torsades de pointes unutar prva tri dana, liječenje dofetilidom mora se započeti u bolnici uz pažljivo praćenje QT intervala i prilagođenja doze u bolesnika s oštećenom bubrežnom funkcijom .…”

Section: 30unclassified

Atrial Fibrillation in Patients with Cardiac Resynchronization Therapy: Therapeutic Options

Petrač¹

2017

Cardiologia Croatica

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Fibrilacija atrija u bolesnika s resinkronizacijskom terapijom srca: terapijske mogućnosti Atrial Fibrillation in Patients with Cardiac Resynchronization Therapy: Therapeutic Options SAŽETAK: Fibrilacija atrija (FA) često je prisutna u bolesnika s resinkronizacijskom terapijom srca (CRT) i može imati znatan negativan utjecaj na prognozu i odgovor na CRT. Liječenje FA-a u bolesnika s CRT-om uključuje optimalnu medikamentu terapiju za zatajivanje srca, antikoagulantnu terapiju i terapiju za kontrolu frekvencije ili kontrolu ritma sa specifičnim ciljem da se osigura visoki postotak (≥98 %) biventrikularne (BiV) stimulacije. U bolesnika sa zatajivanjem srca i FA-om, kontrola ritma antiaritmičnim lijekovima nije uspjela pokazati nikakvu dobit u preživljenju u usporedbi s lijekovima za kontrolu frekvencije. U tom kontekstu kontrola frekvencije lijekovima preferira se kao prvi izbor liječenja u bolesnika s CRT-om i perzistentnom ili trajnom FA. Međutim, opservacijske prospektivne studije i metaanalize pokazuju da je ablacija AV spoja bolja od lijekova za kontrolu frekvencije u postizanju visokog postotka BiV stimulacije i smanjenju smrtnosti. Zbog toga ablacija AV spoja može biti prvi izbor liječenja u bolesnika s CRT-om i trajnom FA. Amiodaron i dofetilid jedini su antiaritmici pogodni za kontrolu ritma u bolesnika s CRT-om, ali uz umjerenu učinkovitost i znatne nuspojave. Kateterska ablacija FA-a drugi je mogući izbor za kontrolu ritma u bolesnika sa CRT-om, jer poboljšava odgovor na CRT pospješujući atrioventrikularnu i interventrikularnu sinkroniju. Prema rezultatima randomiziranih kontroliranih studija u bolesnika sa zatajivanjem srca, ablacija FA može se uzeti u obzir u bolesnika s CRT-om i paroksizmalnom FA, koji ne reagiraju na antiaritmične lijekove, kao i u odabranih bolesnika s perzistentnom FA prije nego što se prihvati terapija za kontrolu frekvencije. SUMMARY:Atrial fibrillation (AF) is often present in patients with cardiac resynchronization therapy (CRT), and may have a significant negative impact on the prognosis and CRT response. Management of AF in CRT patients includes the optimal pharmacological heart failure therapy, anticoagulation therapy, and rate or rhythm control therapy with specific goal to ensure a high percentage (≥98%) of biventricular (BiV) pacing. In heart failure patients with AF, a rhythm control with antiarrhythmic drugs has failed to show any survival benefit compared with a rate control drugs. In this context, a rate control with drugs is preferred as first-line therapy in CRT patients with persistent or permanent AF. However, the observational prospective studies and meta-analyses indicate that AV junction ablation is superior to rate control drugs in achieving adequate BiV pacing and reducing mortality. Therefore, an ablation of AV junction should be considered as the first therapeutic choice in CRT patients with permanent AF. Amiodarone and dofetilide are the lone antiarrhythmic drugs suitable for the rhythm control in CRT patients, but with a moderate efficacy and significant ...

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“…Although rate control was found to be superior to rhythm control in AFFIRM and RACE, subsequent analyses suggested a benefit of maintaining sinus rhythm, which was completely offset by the toxicity of anti-arrhythmic drugs (57,58). One technique of achieving sinus rhythm without anti-arrhythmic drugs would be curative catheter ablation.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

Gupta¹,

Figueredo²

2014

International Journal of Cardiology

106

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Efficacy of Dofetilide in the Treatment of Atrial Fibrillation-Flutter in Patients With Reduced Left Ventricular Function

Abstract: Dofetilide is safe and increases the probability of obtaining and maintaining sinus rhythm in patients with structural heart disease. The present study suggests that restoration of sinus rhythm is associated with improved survival.

Cited by 435 publications

References 21 publications

Relationships Between Sinus Rhythm, Treatment, and Survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study

Relationships Between Sinus Rhythm, Treatment, and Survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study

Atrial Fibrillation in Patients with Cardiac Resynchronization Therapy: Therapeutic Options

Tachycardia mediated cardiomyopathy: Pathophysiology, mechanisms, clinical features and management

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