Singh Steven N
VA Medical Center, Washington, DC 20422, USA.
Card Electrophysiol Rev. 2003 Sep;7(3):225-8. doi: 10.1023/B:CEPR.0000012387.04308.29.
Dofetilide is a class III antiarrhythmic drug (potassium channel blocker) that has been approved by the regulatory agencies in the United States and throughout the world to convert atrial fibrillation and maintain sinus rhythm. Therapy is initiated in-hospital during heart rhythm monitoring. Doses are selected according to the QT interval and estimated creatinine clearance. In patients with heart failure and prior myocardial infarction, dofetilide was very effective in converting atrial fibrillation and maintaining normal sinus rhythm. In patients with persistent atrial fibrillation, dofetilide compared to placebo was significantly better in converting atrial fibrillation and maintaining sinus rhythm. This was especially true for the highest dose of 500 microg twice-a-day. Caution must be used when initiating dofetilide therapy to avoid torsade de pointes ventricular tachycardia, especially in patients with heart failure, hypertrophy, bradycardia and female gender.
多非利特是一种Ⅲ类抗心律失常药物（钾通道阻滞剂），已获美国及全球监管机构批准，用于转复心房颤动并维持窦性心律。治疗在医院内启动，同时进行心律监测。根据QT间期和估算的肌酐清除率选择剂量。在心力衰竭和既往有心肌梗死的患者中，多非利特在转复心房颤动和维持正常窦性心律方面非常有效。在持续性心房颤动患者中，与安慰剂相比，多非利特在转复心房颤动和维持窦性心律方面明显更优。对于每日两次500微克的最高剂量尤其如此。开始多非利特治疗时必须谨慎，以避免尖端扭转型室性心动过速，特别是在心力衰竭、肥厚、心动过缓和女性患者中。
