1 Heart and Vascular Institute, Penn State University College of Medicine, The Milton S. Hershey Medical Center, Hershey, PA, USA.
J Cardiovasc Pharmacol Ther. 2019 Jan;24(1):3-10. doi: 10.1177/1074248418784288. Epub 2018 Jun 25.
Dofetilide is a class III antiarrhythmic agent approved by the Food and Drug Administration for the conversion of atrial fibrillation and atrial flutter and maintenance of sinus rhythm in symptomatic patients with persistent arrhythmia. Drug trials showed neutral mortality in post-myocardial infarction patients and those with heart failure. This is a review of postmarket data, including real-world efficacy and safety in a variety of populations. Dofetilide has been used off-label with success in patients with paroxysmal atrial fibrillation and atrial flutter, as well as atrial tachycardia and ventricular tachycardia. The real-world acute conversion rate of atrial fibrillation and atrial flutter is higher than that reported in clinical trials. Dofetilide has an acceptable safety profile when initiated (or reloaded) under hospital monitoring and dosed according to creatinine clearance. Dofetilide is well tolerated and a good choice for patients with acceptable renal function and a normal QT interval, especially if atrioventricular nodal blockade needs to be avoided.
多非利特是一种 III 类抗心律失常药物，已获美国食品药品监督管理局批准用于转换心房颤动和心房扑动，并维持持续性心律失常有症状患者的窦性节律。药物试验表明，对于心肌梗死后患者和心力衰竭患者，死亡率呈中性。这是对上市后数据的回顾，包括各种人群中的真实世界疗效和安全性。多非利特已成功用于阵发性心房颤动和心房扑动、以及房性心动过速和室性心动过速患者的超适应证用药。在真实世界中，心房颤动和心房扑动的急性转换率高于临床试验报告的结果。在医院监测下启动（或重新加载）并根据肌酐清除率调整剂量时，多非利特具有可接受的安全性。对于肾功能可接受且 QT 间期正常的患者，多非利特耐受良好，是一种不错的选择，尤其是需要避免房室结阻滞的情况下。
