Dofetilide (Tikosyn): A new drug to control atrial fibrillation

ABSTRACT

Dofetilide, a new class III antiarrhythmic agent, selectively blocks a specific cardiac potassium channel, I_Kr, increasing the effective refractory period of the myocyte and thereby terminating reentrant arrhythmias. Given orally, it appears to effectively convert atrial fibrillation and atrial flutter to sinus rhythm and maintain sinus rhythm after conversion in appropriately selected patients. This paper reviews the pharmacology of dofetilide, the evidence of its effectiveness, and the appropriate precautions in using it.