Dofetilide comparable to amiodarone for rhythm control in AF patients
USA: The efficacy of dofetilide (DOF) is as good as amiodarone (AMIO) for rhythm control in atrial fibrillation (AF) patients, finds a recent study in the journal JACC: Clinical Electrophysiology.
The comparative efficacy of DOF versus AMIO in AF patients is not well established. In addition, proarrhythmia has been a concern with DOF therapy. Ghanshyam Shantha, University of Michigan, Ann Arbor, Michigan, USA, and colleagues aimed to compare the efficacy and safety of dofetilide versus amiodarone in AF patients.
For this purpose, the researchers attempted rhythm control using DOF in 657 consecutive patients with AF (n=528) or atrial flutter and AF (n=129) between January 2014 and December 2018.
Key findings of the study include:
- DOF was successfully initiated in 573 (87%) of 657 patients, including 510 (89%) with persistent AF and 63 (11%) with paroxysmal AF.
- During a mean follow-up of 19 ± 7 months, sinus rhythm was maintained in 361 (63%) of the 573 DOF-treated patients.
- At 12 months, patients on DOF had a similar likelihood of experiencing recurrent atrial arrhythmias compared with the 2,476 consecutive patients treated with AMIO for rhythm control during the study period (37% vs. 39%).
- The efficacy of DOF and AMIO was also similar in specific subgroups of patients, including patients >75 years of age, with a low left ventricular ejection fraction, obesity, renal insufficiency, and prior catheter ablation for AF.
- Among patients with atypical atrial flutter, likelihood of recurrent atrial flutter was similar between the DOF (43 of 108 [40%]) and AMIO (211 of 555 [38%]) groups.
"When properly initiated and monitored, DOF has efficacy comparable to that of amiodarone for rhythm control in patients with AF," concluded the authors.
Reference:
The study titled, "Comparative Efficacy of Dofetilide Versus Amiodarone in Patients With Atrial Fibrillation," is published in the journal JACC: Clinical Electrophysiology.
DOI: https://www.jacc.org/doi/10.1016/j.jacep.2020.11.027
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