Focus on dofetilide: A selective class III antiarrhythmic agent for use in atrial fibrillation or atrial flutter

Dofetilide is a novel, selective class III antiarrhythmic agent currently under FDA review for use in terminating atrial fibrillation and atrial flutter and maintaining normal sinus rhythm. In clinical trials, intravenous dofetilide has been shown to be effective for the conversion of atrial fibrillation and atrial flutter to normal sinus rhythm, although conversion rates are higher for atrial flutter. Oral dofetilide has been shown effective for the maintenance of normal sinus rhythm. Dofetilide has a favorable side effect profile compared with other antiarrhythmic agents; however, some cases of torsades de pointes have been reported. The available data suggest that dofetilide, if approved, may offer a useful alternative in the pharmacologic management of atrial fibrillation and atrial flutter.