NEW YORK, Sep 15 (Reuters Health) -- Dofetilide, a new drug used to control certain irregular heart rhythms, reduces hospitalizations for some patients with heart failure, though it has no effect on survival rates.
Used in the hospital in conjunction with heart monitoring, "dofetilide therapy can be used to treat patients with congestive heart failure and atrial fibrillation," according to Dr. Christian Torp-Pedersen from Gentofte University Hospital in Hellerup, Denmark and colleagues writing for the Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group. Their report is published in the September 16th issue of The New England Journal of Medicine.
Dofetilide is an investigational drug being studied as a medication to control arrhythmias, or abnormal heart rhythms, in heart attack patients and in heart failure patients. The study was supported by a grant from Pfizer Central Research in Kent, UK.
Atrial fibrillation, an irregular heart rhythm common in heart failure patients, has been linked to deteriorating heart function and increased risk of hospitalization. The investigators compared the rates of atrial fibrillation, hospitalization, and death between 762 patients treated with dofetilide and 756 patients who received a placebo, or "dummy" pill.
More than 40% of the patients in both groups died during the 3-year study, 41% of those receiving dofetilide and 42% of those taking placebo, according to the report.
Although there was no difference in survival, dofetilide patients were 25% less likely than placebo patients to be hospitalized for worsening heart failure, the authors report.
Furthermore, dofetilide-treated patients with atrial fibrillation were more likely to convert to a normal heart rhythm -- and to maintain that normal rhythm -- than were those receiving placebo, the report indicates.
Except for a propensity to develop serious irregular heart rhythms besides atrial fibrillation, patients treated with dofetilide experienced no more troubling side effects than patients treated with placebo, the investigators write.
The authors speculate that dofetilide's beneficial effects on atrial fibrillation may account for the reduced rates of hospitalization among dofetilide-treated patients.
Despite the findings of this study, dofetilide should not be used routinely to guard against atrial fibrillation in heart failure patients, write Drs. William G. Stevenson and Lynne Warner Stevenson of Brigham and Women's Hospital in Boston, Massachusetts, in a related editorial.
"For certain select patients," said Dr. William Stevenson in an interview with Reuters Health, "dofetilide treatment would be reasonable, so long as you take all the precautions taken in this study."
"Most heart failure patients with persistent atrial fibrillation, though, should be treated with (anti-clotting agents) and drugs to control the overall heart rate," he added.
