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Europace Advance Access originally published online on October 8, 2009
Europace 2009 11(11):1448-1455; doi:10.1093/europace/eup293
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Ablation for Atrial Fibrillation

Dofetilide is safe and effective in preventing atrial fibrillation recurrences in patients accepted for catheter ablation

Yana Shamiss, Yaariv Khaykin*, Richard Oosthuizen, Denise Tunney, Bradley Sarak, Marianne Beardsall, Catherine Seabrook, Linda Frost, Zaev Wulffhart, Bernice Tsang and Atul Verma

Southlake Regional Health Center, 105-712 Davis Drive, Newmarket, ON, Canada L4E 4M5

Aims: The aim of this study was to assess the safety and efficacy of dofetilide among patients refractory to other anti-arrhythmic drugs (AADs) and accepted for atrial fibrillation (AF) ablation.

Methods and results: One hundred and twenty-seven of 454 patients (69% male, 58% paroxysmal, age 60 ± 10 years, AF duration 8 ± 7 years) scheduled for AF ablation between February 2004 and May 2008 were treated with dofetilide. Patients had failed 1.9 ± 1.1 AADs. Anti-arrhythmic drugs were stopped five half-lives before ablation and 3 months for amiodarone. Patients were followed for 15 ± 7 months with routine and symptom-driven monitoring. Success was defined as no further AF and partial success as a 50% reduction in frequency/duration of AF episodes. Thirty-six patients started dofetilide 158 ± 167 days before ablation: 9 had no improvement, 16 experienced partial success, 8 had no further AF, and 2 improved enough to forgo ablation. Seventy-one patients started dofetilide immediately following ablation, of which 14 had no improvement, 22 experienced partial success, and 32 had no further AF. Twenty patients started dofetilide 119 ± 153 days post-ablation, of which four had no improvement, seven experienced partial success, and nine had no further AF. Six patients discontinued dofetilide during initiation for QT prolongation.

Conclusion: Dofetilide appears safe and effective in preventing AF in patients refractory to other AADs undergoing catheter ablation.

Key Words: Dofetilide, Atrial fibrillation, Catheter ablation, Anti-arrhythmic drugs

* Corresponding author. Tel: +1 905 953 7917, Fax: +1 905 953 0046, Email: y.khaykin{at}utoronto.ca

Manuscript submitted 1 April 2009. Accepted after revision 7 September 2009.


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