To minimize the risk of induced arrhythmia, patients initiated or re-initiated on TIKOSYN should be placed for a minimum of 3 days in a facility that can provide calculations of creatinine clearance, continuous electrocardiographic monitoring, and cardiac resuscitation. For detailed instructions regarding dose selection, see DOSAGE AND ADMINISTRATION. TIKOSYN is available only to hospitals and prescribers who have received appropriate TIKOSYN dosing and treatment initiation education, see DOSAGE AND ADMINISTRATION.
TIKOSYN (dofetilide) is an antiarrhythmic drug with Class III (cardiac action potential duration prolonging) properties.
TIKOSYN is indicated for the maintenance of normal sinus rhythm (delay in time to recurrence of atrial fibrillation/atrial flutter [AF/AFl]) in patients with atrial fibrillation/atrial flutter of greater than one week duration who have been converted to normal sinus rhythm. Because TIKOSYN can cause life threatening ventricular arrhythmias, it should be reserved for patients in whom atrial fibrillation/atrial flutter is highly symptomatic.
In general, antiarrhythmic therapy for atrial fibrillation/atrial flutter aims to prolong the time in normal sinus rhythm. Recurrence is expected in some patients. (See CLINICAL TRIALS.)
TIKOSYN is indicated for the conversion of atrial fibrillation and atrial flutter to normal sinus rhythm.
TIKOSYN has not been shown to be effective in patients with paroxysmal atrial fibrillation.
Published Studies Related to Tikosyn (Dofetilide)
Risk factors and predictors of Torsade de pointes ventricular tachycardia in patients with left ventricular systolic dysfunction receiving Dofetilide. [2007.09.01]
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)... Patients with recent MI less often had TdP compared with patients with chronic HF.
An evaluation of the impact of oral magnesium lactate on the corrected QT interval of patients receiving sotalol or dofetilide to prevent atrial or ventricular tachyarrhythmia recurrence. [2006.04]
BACKGROUND: Intravenous magnesium reduces the QTc interval of patients receiving ibutilide. Whether oral magnesium can reduce the QTc interval associated with oral sotalol and dofetilide is not known. This study was undertaken to evaluate the impact of oral magnesium on the QTc interval and whether an inherent intracellular magnesium deficiency exists among patients with arrhythmias... CONCLUSIONS: Oral magnesium l-lactate raises intracellular magnesium concentrations and lowers the QTc interval of patients receiving sotalol or dofetilide.
Phase IV trial evaluating the effectiveness and safety of dofetilide. [2004.07]
BACKGROUND: Dofetilide gained Food and Drug Administration approval for persistent atrial fibrillation/flutter (AFF) based on 2 randomized, placebo-controlled, dose-ranging studies. Concerns of proarrhythmia have prompted the manufacturer to develop specific treatment guidelines. OBJECTIVE: To determine the effectiveness and safety of dofetilide in clinical practice as well as to ascertain whether clinicians are following established dosing guidelines... CONCLUSIONS: In clinical practice, the conversion of persistent AFF with dofetilide is at least comparable to premarketing studies, with a similar safety profile. Institutions should continue to emphasize adherence with established treatment guidelines.
The prognostic value of QTc interval and QT dispersion following myocardial infarction in patients treated with or without dofetilide. [2003.05]
BACKGROUND: Acute myocardial infarction (MI) is associated with an increased risk of death, with a 1-year mortality close to 10% in patients discharged from hospital alive. During the first year following MI, close to 50% of deaths are assumed to be due to arrhythmic events. HYPOTHESIS: The study was undertaken to determine the interaction between dofetilide treatment and pretreatment QTc interval and QT dispersion regarding mortality in patients with left ventricular (LV) dysfunction and a recent MI... CONCLUSION: In patients with a recent MI, LV dysfunction, and a short baseline QTc interval, dofetilide is associated with significant survival benefit. This benefit is not seen with a longer QTc interval. QT dispersion is not a risk factor in this population.
Survival after withdrawal of dofetilide in patients with congestive heart failure and a short baseline QTc interval; a follow-up on the Diamond-CHF QT substudy. [2003.02]
BACKGROUND: We have previously observed dofetilide to be associated with improved survival when the pre-treatment baseline QTc interval was below 429 ms. In this study we tested the natural extension of this observation-that the same group of patients should have a loss of survival benefit after withdrawal of dofetilide... CONCLUSIONS: This follow-up study shows significant loss of survival benefit upon withdrawal of dofetilide in patients with CHF and a pre-treatment QTc interval below 429 ms. An independent randomized trial is warranted to validate these results.
Clinical Trials Related to Tikosyn (Dofetilide)
High Intensity Focused Ultrasound (HIFU) Ablation System Study [Suspended]
The purpose of this study is to determine if the HIFU Pulmonary Vein Ablation System is
effective in the treatment of paroxysmal Atrial Fibrillation compared to the control of best
medical therapy with FDA approved antiarrhythmic drugs.
Catheter Ablation for Recently Diagnosed Paroxysmal Atrial Fibrillation [Recruiting]
The objective is to compare the progression of Atrial Fib (AF) burden by continuous
monitoring in patients with recently diagnosed paroxysmal AF treated by catheter ablation
(PVI) versus anti-arrhythmic drug (AAD) therapy.
A Study of the Effectiveness of Anti-Arrhythmic Medications After Atrial Fibrillation Ablation [Recruiting]
Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia [Not yet recruiting]
Implantable Cardioverter Defibrillators (ICDs) provide a shock or pacing therapy to bring
back a normal heart beat when a patient experiences a dangerous abnormal heart rhythm such
as ventricular tachycardia (VT). ICDs are very successful in bringing back a normal heart
beat when VT occurs, but they do not prevent further dangerous heart rhythms from occurring.
This study is designed to determine the best way to manage patients who have an ICD and who
continue to have episodes of VT. There are two methods for treatment the VT: 1) Ablation,
and 2) Medication.
An ablation procedure involves placing a flexible catheter (insulated wire) in the groin
area and threading it into the heart. After the doctor has located the affected area
responsible for the VT, radiofrequency energy is delivered by the power generator through
the catheter to the inside of the heart. The radiofrequency energy ablates (burns) a small
area of the heart tissue thought to cause the VT.
A medication called Amiodarone is an "anti-arrhythmic" prescribed to prevent abnormal heart
rhythms from recurring.
The purpose of this study is to compare these two different methods for treating VT.
Treatment with ablation and amiodarone are both considered the standard of care for patients
with VT but they have not been compared directly in a study like this before.
AV Node Ablation and Pacemaker Therapy Compared to Drug Therapy for Atrial Fibrillation - Pilot Study [Recruiting]
The purpose of this study is to determine whether early atrioventricular node (AVN) ablation
with pacing device therapy will reduce death and hospitalization when compared to the
conventional drug therapy in elderly patients with recurrent and symptomatic atrial
Reports of Suspected Tikosyn (Dofetilide) Side Effects
Electrocardiogram QT Prolonged (33),
Drug Ineffective (32),
Atrial Fibrillation (32),
Drug Interaction (21),
Dyspnoea (20), more >>