Dofetilide use is not associated with increased mortality in patients with left ventricular hypertrophy and atrial fibrillation

作者：Daniel Wann, Brent Medoff, Noor‐ul‐huda A. Mehdi, Ahmet Sezer, Floyd Thoma, Suresh Mulukutla, Aditya Bhonsale, N.A. Mark Estes, Samir Saba, Sandeep Jain, and other members of the UPMC Study Group · 发表于：Journal of Cardiovascular Electrophysiology · 年份：2022 · DOI：10.1111/jce.15733 · 被引用次数：3 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiac electrophysiology and arrhythmias、Cardiac pacing and defibrillation studies

BACKGROUND: Left ventricular hypertrophy (LVH) is common in patients with atrial fibrillation (AF), however, many antiarrhythmic drugs (AADs) are contraindicated. US guidelines recommend avoiding pure class III antiarrhythmics such as dofetilide in patients with significant LVH due to concern for an increased risk of death, however, clinical data is lacking. We sought to determine if dofetilide use was associated with increased mortality in patients with LVH. METHODS: Patients ≥18 years of age with AF and LVH ≥ 1.4 cm were included. A group of patients treated with dofetilide and a control group of patients without a history of AAD use were propensity matched. The primary outcome was all-cause mortality at 3 years and secondary outcomes were total number of all-cause hospitalizations and hospitalizations related to AF. RESULTS: There were 359 patients in each of the groups. Baseline variables were well-matched. The primary outcome of all-cause mortality occurred in 7% of patients in the dofetilide group and 12% of patients in the control group (hazard ratio: 0.90, 95% confidence interval: 0.53-1.53). Total all-cause hospitalizations were higher in the control group but hospitalizations for AF were no different. CONCLUSIONS: In a propensity-matched cohort of 718 patients with AF and LVH, dofetilide was not associated with increased mortality at 3 years. Our study adds to prior data demonstrating the safety of dofetilide in this population despite guideline recommendations agai...