Dofetilide, a New Class III Antiarrhythmic Agent

Dofetilide is a new antiarrhythmic agent recently approved for conversion and maintenance of sinus rhythm in patients with atrial fibrillation (AF) and atrial flutter (AFl). It is a class III antiarrhythmic that works by selectively blocking the rapid component of the delayed rectifier outward potas...

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Bibliographic Details
Published in:Pharmacotherapy 2000-07, Vol.20 (7), p.776-786
Main Authors: Lenz, Thomas L., Hilleman, Daniel E.
Format: Article
Language:English
Subjects:
Animals
Anti-Arrhythmia Agents - adverse effects
Anti-Arrhythmia Agents - pharmacology
Anti-Arrhythmia Agents - therapeutic use
Antiarythmic agents
Arrhythmias, Cardiac - drug therapy
Biological and medical sciences
Cardiovascular system
Humans
Medical sciences
Pharmacology. Drug treatments
Phenethylamines - adverse effects
Phenethylamines - pharmacology
Phenethylamines - therapeutic use
Sulfonamides - adverse effects
Sulfonamides - pharmacology
Sulfonamides - therapeutic use
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Summary:Dofetilide is a new antiarrhythmic agent recently approved for conversion and maintenance of sinus rhythm in patients with atrial fibrillation (AF) and atrial flutter (AFl). It is a class III antiarrhythmic that works by selectively blocking the rapid component of the delayed rectifier outward potassium current. Dofetilide prolongs the effective refractory period in accessory pathways, both anterograde and retrograde. This can be seen on the electrocardiogram through a dose‐dependent prolongation of the QT and QTc intervals, with parallel increases in ventricular refractoriness. Approximately 80% of drug is excreted in urine, so dosing must be based on creatinine clearance. The elimination half‐life is approximately 10 hours. In clinical trials dofetilide was superior to flecainide in converting patients with AFl to normal sinus rhythm (NSR; 70% vs 9%, p
ISSN:0277-0008
1875-9114
DOI:10.1592/phco.20.9.776.35208