Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy
Abstract Background Professional society practice guidelines conflict regarding their recommendations of dofetilide (DOF) and sotalol (STL) for treatment of arrhythmias in hypertrophic cardiomyopathy (HCM), and supporting data is sparse. We aim to assess safety and efficacy of DOF and STL on arrhyth...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-07-01
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| Series: | Communications Medicine |
| Online Access: | https://doi.org/10.1038/s43856-023-00315-8 |
| _version_ | 1797773954011627520 |
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| author | Chris Chen Mallika Lal Yunwoo Burton Hongya Chen Eric Stecker Ahmad Masri Babak Nazer |
| author_facet | Chris Chen Mallika Lal Yunwoo Burton Hongya Chen Eric Stecker Ahmad Masri Babak Nazer |
| author_sort | Chris Chen |
| collection | DOAJ |
| description | Abstract Background Professional society practice guidelines conflict regarding their recommendations of dofetilide (DOF) and sotalol (STL) for treatment of arrhythmias in hypertrophic cardiomyopathy (HCM), and supporting data is sparse. We aim to assess safety and efficacy of DOF and STL on arrhythmias in HCM. Methods This was an observational study of HCM patients treated with DOF or STL for atrial fibrillation (AF) and ventricular arrhythmias (VA). Outcomes of drug discontinuation and arrhythmia recurrence were compared at 1 year and latest follow-up by Kaplan–Meier analysis. Predictors of drug failure were studied using uni- and multi-variable analyses. Drug-related adverse events were quantitated. Results Here we show that of our cohort of 72 patients (54 ± 14 years old, 75% male), 21 were prescribed DOF for AF, 52 STL for AF, and 18 STL for VA. At 1 year, discontinuation and recurrence rates were similar for DOF-AF (38% and 43%) and STL-AF (29% and 44%) groups. Efficacy data was similar at long-term follow-up of 1603 (IQR 994–4131) days, and for STL-VA. Drug inefficacy was the most common reason for discontinuation (28%) followed by side-effects (13%). Incidences of heart failure hospitalization (5%) and mortality (3%) were low. One STL-AF patient developed non-sustained torsades de pointes in the setting of severe pneumonia and acute kidney injury, but there were no other drug-related serious adverse events. Conclusions DOF and STL demonstrate modest efficacy and satisfactory safety when used for AF and VA in HCM patients. |
| first_indexed | 2024-03-12T22:13:43Z |
| format | Article |
| id | doaj.art-627e232b03c04bb083d693a9b84d706c |
| institution | Directory Open Access Journal |
| issn | 2730-664X |
| language | English |
| last_indexed | 2024-03-12T22:13:43Z |
| publishDate | 2023-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Communications Medicine |
| spelling | doaj.art-627e232b03c04bb083d693a9b84d706c2023-07-23T11:25:11ZengNature PortfolioCommunications Medicine2730-664X2023-07-01311710.1038/s43856-023-00315-8Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathyChris Chen0Mallika Lal1Yunwoo Burton2Hongya Chen3Eric Stecker4Ahmad Masri5Babak Nazer6Knight Cardiovascular Institute, Oregon Health & Science UniversityKnight Cardiovascular Institute, Oregon Health & Science UniversityKnight Cardiovascular Institute, Oregon Health & Science UniversityKnight Cardiovascular Institute, Oregon Health & Science UniversityKnight Cardiovascular Institute, Oregon Health & Science UniversityKnight Cardiovascular Institute, Oregon Health & Science UniversityUW Medicine Heart Institute, University of WashingtonAbstract Background Professional society practice guidelines conflict regarding their recommendations of dofetilide (DOF) and sotalol (STL) for treatment of arrhythmias in hypertrophic cardiomyopathy (HCM), and supporting data is sparse. We aim to assess safety and efficacy of DOF and STL on arrhythmias in HCM. Methods This was an observational study of HCM patients treated with DOF or STL for atrial fibrillation (AF) and ventricular arrhythmias (VA). Outcomes of drug discontinuation and arrhythmia recurrence were compared at 1 year and latest follow-up by Kaplan–Meier analysis. Predictors of drug failure were studied using uni- and multi-variable analyses. Drug-related adverse events were quantitated. Results Here we show that of our cohort of 72 patients (54 ± 14 years old, 75% male), 21 were prescribed DOF for AF, 52 STL for AF, and 18 STL for VA. At 1 year, discontinuation and recurrence rates were similar for DOF-AF (38% and 43%) and STL-AF (29% and 44%) groups. Efficacy data was similar at long-term follow-up of 1603 (IQR 994–4131) days, and for STL-VA. Drug inefficacy was the most common reason for discontinuation (28%) followed by side-effects (13%). Incidences of heart failure hospitalization (5%) and mortality (3%) were low. One STL-AF patient developed non-sustained torsades de pointes in the setting of severe pneumonia and acute kidney injury, but there were no other drug-related serious adverse events. Conclusions DOF and STL demonstrate modest efficacy and satisfactory safety when used for AF and VA in HCM patients.https://doi.org/10.1038/s43856-023-00315-8 |
| spellingShingle | Chris Chen Mallika Lal Yunwoo Burton Hongya Chen Eric Stecker Ahmad Masri Babak Nazer Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy Communications Medicine |
| title | Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy |
| title_full | Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy |
| title_fullStr | Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy |
| title_full_unstemmed | Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy |
| title_short | Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy |
| title_sort | efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy |
| url | https://doi.org/10.1038/s43856-023-00315-8 |
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