Effect of dofetilide on QT dispersion and the prognostic implications of changes in QT dispersion for patients with congestive heart failure.

Abstract

AIMS:

Drug-induced changes in QT dispersion may be a way of detecting harmful repolarisation abnormalities for patients receiving antiarrhythmic drugs affecting ventricular repolarisation.

METHODS AND RESULTS:

In 463 congestive heart failure (CHF) patients enrolled in the Danish Investigations Of Arrhythmia and Mortality On Dofetilide-CHF (DIAMOND-CHF) study, both pre-treatment and on-treatment day 2-6 QT dispersion was available from standard 12-lead ECGs. Patients were randomised in a double-blind manner to receive either placebo or dofetilide, a new class III antiarrhythmic drug. During a median follow-up of 19 months (minimum 1 year), 179 patients (39%) died (135 patients from cardiac causes). Changes in QT dispersion did not predict all-cause or cardiac mortality for patients treated with dofetilide in multivariate survival analysis (Risk ratio: 1.02, 95% confidence interval: 0.97-1.08, P>0.4). This finding was independent of pre-treatment QT dispersion. Dofetilide caused a small QT dispersion increment of 8 ms, not different from the changes seen in the placebo group (3 ms).

CONCLUSION:

For patients with CHF and reduced left ventricular systolic function, changes in QT dispersion following treatment with dofetilide do not predict all-cause or cardiac mortality. The dofetilide-induced QT dispersion changes are small and comparable to those seen in placebo treated patients.

• Authors: Bente Brendorp, Hanne Elming, Li Jun, Lars Køber, Christian Torp-Pedersen, DIAMOND Study Group. Danish Investigations Of Arrhythmia and Mortality On Dofetilide
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 4 Issue 2 Pg. 201-6 (Mar 2002) ISSN: 1388-9842 [Print] England
• PMID: 11959050 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Arrhythmia Agents
• Phenethylamines
• Potassium Channel Blockers
• Sulfonamides
• dofetilide

Topics

• Aged
• Aged, 80 and over
• Anti-Arrhythmia Agents (therapeutic use)
• Double-Blind Method
• Electrocardiography
• Endpoint Determination
• Female
• Follow-Up Studies
• Heart Failure (diagnosis, drug therapy, mortality)
• Humans
• Long QT Syndrome (chemically induced, diagnosis, mortality)
• Male
• Middle Aged
• Multivariate Analysis
• Observer Variation
• Phenethylamines (therapeutic use)
• Potassium Channel Blockers
• Prognosis
• Reproducibility of Results
• Sulfonamides (therapeutic use)
• Survival Analysis
• Treatment Outcome
• Ventricular Dysfunction, Left (drug therapy, mortality)