Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide
Research output: Contribution to journal › Journal article › Research › peer-review
The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) studies enrolled patients with HF (DIAMOND-HF) or MI (DIAMOND-MI) and left ventricular systolic dysfunction. The present analysis includes only patients treated solely with dofetilide. The incidence of TdP was 2.1% (32 of 1,511). Twenty-five of the incidences occurred in the DIAMOND-HF study and 7 cases in the DIAMOND-MI study (p = 0.0015). TdP was more frequent in women than in men (47% vs 28%, p = 0.02). Risk factors for developing TdP were female gender (odds ratio 2.2, 95% confidence interval [CI] 1.0 to 5.0), MI within 8 weeks (odds ratio 0.3, 95% CI 0.1 to 0.7), being in New York Heart Association class III or IV (odds ratio 3.2, 95% CI 1.2 to 8.6), and baseline QTc duration (odds ratio 1.14, 95% CI 1.00 to 1.30) per 10 ms. Women with chronic HF, QTc duration >400 ms. and New York Heart Association class III or IV had a risk of TdP of 10%, whereas no TdP episodes were observed in patients with QTc duration <400 ms. In conclusion, severity of HF, female gender, and QTc duration make it possible to identify patients with a high risk of early TdP when treated with dofetilide. Patients with recent MI less often had TdP compared with patients with chronic HF.
Original language | English |
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Journal | American Journal of Cardiology |
Volume | 100 |
Issue number | 5 |
Pages (from-to) | 876-80 |
Number of pages | 4 |
ISSN | 0002-9149 |
DOIs | |
Publication status | Published - 2007 |
Bibliographical note
Keywords: Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Cardiac Output, Low; Cause of Death; Double-Blind Method; Electrocardiography; Female; Forecasting; Heart Arrest; Humans; Male; Middle Aged; Myocardial Infarction; Phenethylamines; Placebos; Potassium Channel Blockers; Risk Factors; Sex Factors; Sulfonamides; Time Factors; Torsades de Pointes; Ventricular Dysfunction, Left
ID: 17395702