Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .
Efficacy and safety of dofetilide, a new class III antiarrhythmic agent, in acute termination of atrial fibrillation or flutter after coronary artery bypass surgery. Dofetilide Post-CABG Study Group.
Ninety-eight patients , who developed atrial fibrillation/flutter after coronary artery bypass grafting within 1 - 6 days after surgery , were included into a double-blind , placebo-controlled , r and omized trial to assess the efficacy and safety of dofetilide . Patients were r and omly allocated to dofetilide 4 micrograms/kg i.v . ( n = 33 ) , dofetilide 8 micrograms/kg i.v . ( n = 32 ) or placebo ( n = 33 ) given intravenously over 15 min at a constant infusion rate . Responders were defined as patients who converted to sinus rhythm at any time during the initial 3 h after the start of the infusion . The conversion rates were 24 % ( 8/33 ) on placebo , 36 % ( 12/33 ) on dofetilide 4 micrograms/kg , and 44 % ( 14/32 ) on dofetilide 8 micrograms/kg . The P-values ( two-tailed ) were 0.27 for dofetilide 4 micrograms/kg vs. placebo , 0.11 for dofetilide 8 micrograms/kg vs. placebo , and 0.10 for dose-response relationship . Short episodes of aberrant ventricular conduction and ventricular tachycardia were seen separately in three subjects after dofetilide 8 micrograms/kg . No episodes of torsades de pointes were noted . No negative inotropic effect was noted . In conclusion , dofetilide was well tolerated , but the effects on atrial fibrillation/flutter did not attain statistical significance , possibly due to the high placebo conversion rate
Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .