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Role of dofetilide in patients with ventricular arrhythmias

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background or Purpose

To assess effectiveness of dofetilide in reducing the burden of ventricular arrhythmias (VAs).

Background

Prior small sample studies show that dofetilide has benefit in reducing VA. However, large sample investigations with long-term follow-up are lacking.

Methods

Two hundred seventeen consecutive patients admitted between January 2015 and December 2021 for dofetilide initiation for control of VA were assessed. Dofetilide was successfully started in 176 patients (81%) and had to be discontinued in the remaining 41 patients (19%). Dofetilide was initiated for control of ventricular tachycardia (VT) in 136 patients (77%), whereas 40 (23%) patients were initiated on dofetilide for reducing the burden of premature ventricular complexes (PVCs).

Results

The mean follow-up was 24 ± 7 months. In total, among the 136 VT patients, 33 (24%) died, 11 (8%) received a left ventricular assist device (LVAD), and 3 (2%) received a heart transplant during follow-up. Dofetilide was discontinued in 117 (86%) patients due to lack of sustained effectiveness during follow-up. Dofetilide use was associated with similar odds of the composite outcome of all-cause mortality/LVAD/heart transplant (OR: 0.97, 0.55–4.23) in patients with ischemic cardiomyopathy (ICM) compared to those with non-ischemic cardiomyopathy (NICM). Dofetilide did not reduce PVC burden during follow-up in the 40 patients with PVCs (mean baseline PVC burden: 15%, at 1-year follow-up: 14%).

Conclusions

Dofetilide use was less effective in reducing VA burden in our cohort of patients. Randomized controlled studies are needed to confirm our findings.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Cardiac Electrophysiology, Wake Forest University, 1, Medical Center Blvd, Winston-Salem, NC, 27157, USA

    Ghanshyam Shantha, Patrick Kozak, George Bodziock, Patrick Whalen & Prashant Bhave

  2. WellSpan Hospital, York, PA, USA

    Matthew Singleton

  3. Cardiac Electrophysiology, University of Arkansas, Little Rock, USA

    Auras R. Atreya

  4. Debakey Cardiovascular Center, Houston Methodist Hospital, Houston, TX, USA

    Bharat Narasimhan

  5. Cardiac Electrophysiology, Mayo Clinic, Rochester, MN, USA

    Abhishek Deshmukh

  6. Cardiac Electrophysiology, University of Michigan, Ann Arbor, MI, USA

    Jackson J. Liang

  7. University of North Carolina, Chapel Hill, NC, USA

    Patrick Hranitzky

Authors
  1. Ghanshyam Shantha
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  2. Matthew Singleton
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  3. Patrick Kozak
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  4. George Bodziock
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  5. Auras R. Atreya
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  6. Bharat Narasimhan
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  7. Abhishek Deshmukh
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  8. Jackson J. Liang
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  9. Patrick Hranitzky
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  10. Patrick Whalen
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  11. Prashant Bhave
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Corresponding author

Correspondence to Ghanshyam Shantha.

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Ethical approval

The study protocol was approved by the Institutional Review Board of the Wake Forest University, Winston-Salem, NC, USA.

Informed consent

Being a retrospective cohort analysis of de-identified data, informed consent was waived.

Conflict of interest

The authors declare no competing interests.

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Shantha, G., Singleton, M., Kozak, P. et al. Role of dofetilide in patients with ventricular arrhythmias. J Interv Card Electrophysiol 67, 91–97 (2024). https://doi.org/10.1007/s10840-023-01578-w

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  • DOI: https://doi.org/10.1007/s10840-023-01578-w

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