Key result
The CYP2D6 poor metabolizer genotype increased serious side effects with Amiodarone (OR 4.51; 95% CI 1.90-10.74), and the SCN5A rs7626962 variant increased AF recurrence with Class I AADs.
Why the study?
The efficacy and safety of Class I and Class III anti-arrhythmic drugs in AF treatment can vary depending on patient genetics.
Do specific polymorphisms in the CYP2D6, KCNH2, and SCN5A genes affect the efficacy and safety of Class I and Class III anti-arrhythmic drugs in patients with atrial fibrillation?
Cohort (n=112)
Do specific polymorphisms in the CYP2D6, KCNH2, and SCN5A genes affect the efficacy and safety of Class I and Class III anti-arrhythmic drugs in patients with atrial fibrillation?
Odds Ratio: 4.51 (95% CI 1.9–10.74)
Pharmacogenetic variants in CYP2D6 and SCN5A significantly impact the safety and efficacy of anti-arrhythmic drugs in atrial fibrillation, highlighting the potential utility of genetic testing for personalized therapy.
CYP2D6 and SCN5A variants were associated with amiodarone toxicity and Class I AAD failure in AF; leaves open whether genotyping improves outcomes.
The efficacy and safety of Class I and Class III anti-arrhythmic drugs (AADs) in the treatment of Atrial Fibrillation (AF) can vary depending on patient genetics. This prospective cohort study evaluated the association between specific polymorphisms in the CYP2D6, KCNH2, and SCN5A genes and AAD response in 112 AF patients. The CYP2D6 poor metabolizer genotype was found to significantly increase the risk of serious side effects associated with Amiodarone (OR: 4.51, 95% CI: 1.90–10.74). The SCN5A rs7626962 variant was associated with an increased risk of AF recurrence in patients treated with Class I AADs (HR: 2.15, 95% CI: 1.55–2.98). The results suggest that pharmacogenetic testing could guide personalized treatment selection in AF.
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Babak et al. (2025) conducted a cohort in Atrial Fibrillation (n=112). CYP2D6, KCNH2, and SCN5A gene polymorphisms was evaluated on Serious side effects associated with Amiodarone (OR 4.51, 95% CI 1.90-10.74). The CYP2D6 poor metabolizer genotype increased serious side effects with Amiodarone (OR 4.51; 95% CI 1.90-10.74), and the SCN5A rs7626962 variant increased AF recurrence with Class I AADs.
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