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 .
[Dofetilide to patients with heart failure and left ventricular dysfunction].
INTRODUCTION Dofetilide , a new class III antiarrhythmic drug , was tested for its ability to reduce mortality and morbidity in patients with congestive heart failure and left ventricular dysfunction . METHODS In 34 Danish centers , 1518 patients with NYHA class III or IV heart failure and wall motion index of the left ventricle < or = 1.2 ( ejection fraction < or = 35 % ) were r and omized to receive dofetilide or placebo in a double blind study . The dose of dofetilide was adjusted to renal function and the QT interval . Patients were monitored continuously with ekg during the first three days in the study . Minimum follow up was one year . RESULTS Dofetilide did not affect mortality . Hospitalizations for worsening of heart failure were reduced significantly , hazard ratio 0.75 ( 0.63 - 0.89 ) Dofetilide effectively converted atrial fibrillation to sinus rhythm . After one year , 61 % of patients with atrial fibrillation had converted on dofetilide and 33 % on placebo ( p < 0.001 ) . DISCUSSION Dofetilide can be used to convert atrial fibrillation to sinus rhythm and to maintain sinus rhythm in patients with congestive heart failure and left ventricular dysfunction .  Dofetilide does not affect mortality
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 .