Abstract
Background: Although suppression of premature ventricular contractions (PVCs) is not a predictor of mortality over the long term, the extent of PVC suppression is an important characteristic of any antiarrhythmic drug.
Hypothesis: This study was undertaken to determine whether intravenous (IV) dofetilide has the ability to suppress PVCs in patients who have frequent occurrences.
Methods: Subjects were men and women, aged 18 to 75 years, with > 30 PVCs/h on two consecutive 24‐h Holter recordings while drug free, and > 50 PVCs/h during a 2‐hour telemetric electrocardiogram. The study was randomized, double‐blind, and placebo controlled. Subjects received a single‐blind, IV infusion of placebo and were randomized (3:1) to receive a double‐blind second infusion of placebo or an infusion of dofetilide (a 15‐min loading infusion of 4 g/kg followed by a 60‐min maintenance infusion of 3.5 g/kg, for a total dose of 7.5 g/kg).
Results: Dofetilide produced an 82.6% and placebo a 2.9% median reduction in PVCs. Drug responder rate, defined as 80% reduction in PVCs, was 50% in the dofetilide group and 0% in the placebo group.
Conclusion: Intravenous dofetilide significantly reduced PVCs in patients who had > 30 PVCs/h at baseline, and it produced ≥ 80% reduction in PVCs in 50% of all subjects.
Keywords: premature ventricular contractions, dofetilide, class III antiarrhythmic, ventricular arrhythmia
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Reference
- 1. Suttorp MJ, Polak PE, van't Hof A, Rasmussen HS, Dunselman PH, Kingma JH: Efficacy and safety of a new selective class III antiarrhythmic agent dofetilide in paroxysmal atrial fibrillation or atrial flutter. Am J Cardiol 1992; 69: 417–419 [DOI] [PubMed] [Google Scholar]
- 2. Falk RH, Pollak A, Singh SN, Friedrich T, for the Intravenous Dofetilide Investigators : Intravenous dofetilide, a class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter. Intravenous Dofetilide Investigators. J Am Coll Cardiol 1997; 29: 385–390 [DOI] [PubMed] [Google Scholar]
- 3. Ferguson JJ: DIAMOND. In Meeting Highlights, XIXth Congress of the European Society of Cardiology. Circulation 1997; 96: 3820 [Google Scholar]
- 4. Epstein AE, Hallstrom AP, Rogers WJ, Liebson PR, Seals AA, Anderson JL, Cohen JD, Capone RJ, Wyse DG, for the CAST Investigators : Mortality following ventricular arrhythmia suppression by encainide, flecainide, and moricizine after myocardial infarction. The original design concept of the Cardiac Arrhythmia Suppression Trial (CAST). J Am Med Assoc 1993; 270: 2451–2455 [PubMed] [Google Scholar]
- 5. Anderson JL: Comparisons of efficacy and tolerance of moricizine with other antiarrhythmic agents in the treatment of chronic ventricular arrhythmias. Am J Cardiol 1990; 65: 32D–40D [DOI] [PubMed] [Google Scholar]
- 6. Ruskin JN: The Cardiac Arrhythmia Suppression Trial (CAST). N Engl J Med 1989; 321: 386–388 [DOI] [PubMed] [Google Scholar]