Dofetilide for atrial arrhythmias in congenital heart disease: A multicenter study

Ronald Wells, Paul Khairy, Louise Harris, C. Christian Anderson, Seshadri Balaji

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Background: Very little is known about use of the class III antiarrhythmic dofetilide in patients with congenital heart disease (CHD). Methods: A multicenter retrospective review of experience with dofetilide in CHD patients was undertaken. Results: Twenty adults with CHD and refractory atrial arrhythmias were treated with dofetilide at four institutions over a 7-year period. Three (15%) experienced adverse effects during in-hospital initiation of dofetilide (two with torsade de pointes, one with excessive QTc prolongation) and were not continued on this therapy. The remaining 17 were discharged taking dofetilide, with either resolved or improved arrhythmia. One was lost to follow-up. Five subsequently discontinued dofetilide due to waning effectiveness, manifest by recurrence of their arrhythmias. Eleven (55%) remained on dofetilide at most recent visit, with a median follow-up of nearly 1 year. Seven of these 11, or 35% of the CHD patients originally started on dofetilide, experienced a complete resolution of their arrhythmia. The remaining four had breakthrough episodes of atrial arrhythmia, but remained on dofetilide. No patient experienced torsade de pointes after the in-hospital initiation period. Conclusions: Used appropriately, dofetilide appears to be a viable adjunct to catheter-based ablation and alternative pharmacological approaches for the treatment of atrial arrhythmias in adult patients with congenital heart disease. (PACE 2009; 1313-1318).

Original languageEnglish (US)
Pages (from-to)1313-1318
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume32
Issue number10
DOIs
StatePublished - Oct 1 2009

Keywords

  • Pediatrics
  • Pharmacology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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