Key result
Dofetilide use requires strict dosing criteria guided by renal function, QT interval, and concomitant drug therapy to minimize the risk of torsade de pointes and QT prolongation.
Why the study?
What are the mechanisms, risk factors, and management strategies for dofetilide-induced torsade de pointes?
What are the mechanisms, risk factors, and management strategies for dofetilide-induced torsade de pointes?
Dofetilide-induced torsade de pointes can be minimized with strict dosing criteria based on renal function, QT interval, and concomitant medications.
Supports strict dofetilide dosing protocols in practice; leaves open need for prospective outcome studies in modern cohorts.
Dofetilide is an effective antiarrhythmic agent for conversion of atrial fibrillation and atrial flutter as well as maintenance of sinus rhythm in appropriately selected patients. However, as with other antiarrhythmic agents, proarrhythmia is a known adverse effect. The risk of dofetilide induced torsade de pointes (Tdp) is low when used with strict dosing criteria guided by renal function, QT interval and concomitant drug therapy. Benefit from dofetilide use must be individualized and weighed against the side effects and the role of other available treatment options. In this review, we discuss the underlying mechanism, risk factors and precautionary measures to avoid dofetilide induced QT prolongation and ventricular tachycardia/Tdp. We suggest a scheme for the management of QT prolongation, ventricular arrhythmia and Tdp as well.
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Jaiswal et al. (2014) conducted a review in Atrial fibrillation, atrial flutter, and dofetilide-induced torsade de pointes. Dofetilide was evaluated on Dofetilide-induced torsade de pointes (Tdp) and QT prolongation. Dofetilide use requires strict dosing criteria guided by renal function, QT interval, and concomitant drug therapy to minimize the risk of torsade de pointes and QT prolongation.
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