Pause-dependent polymorphic ventricular tachycardia during long-term treatment with dofetilide: A placebo-controlled, implantable cardioverter-defibrillator-based evaluation

Alexander Mazur, Mark Anderson, Sharon Bonney, Dan M. Roden

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To compare the incidence of pause-dependent polymorphic ventricular tachycardia (PVT) in patients with implantable cardioverter-defibrillators (ICDs) randomly assigned to the QT-prolonging antiarrhythmic dofetilide or placebo. BACKGROUND: Drug-related torsade de pointes (TdP) is usually recognized within days of initiating therapy, but its incidence during long-term therapy is unknown. METHODS: We assessed the frequency of TdP and ICD electrograms compatible with TdP in a multicenter study that randomized ICD patients to placebo (n = 87) or dofetilide (n = 87). As reported elsewhere, the number of patients with a primary trial end point (ICD intervention for VT or ventricular fibrillation) was similar in the two groups. For this analysis, a qualifying event was TdP (on electrocardiogram) or an intracardiac electrogram showing pause-dependent PVT. RESULTS: A total of 620 electrograms obtained in 131 patients were analyzed blindly by prospectively defined criteria for episodes of pause-dependent polymorphic VT. These were identified in 15/87 (17%) patients receiving dofetilide and 5/87 (6%) patients on placebo (p <0.05). Five of these episodes were early (

Original languageEnglish (US)
Pages (from-to)1100-1105
Number of pages6
JournalJournal of the American College of Cardiology
Volume37
Issue number4
DOIs
StatePublished - Mar 15 2001
Externally publishedYes

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Implantable Defibrillators
Ventricular Tachycardia
Torsades de Pointes
Placebos
Therapeutics
Cardiac Electrophysiologic Techniques
Incidence
Ventricular Fibrillation
Multicenter Studies
dofetilide
Electrocardiography
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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title = "Pause-dependent polymorphic ventricular tachycardia during long-term treatment with dofetilide: A placebo-controlled, implantable cardioverter-defibrillator-based evaluation",
abstract = "OBJECTIVES: To compare the incidence of pause-dependent polymorphic ventricular tachycardia (PVT) in patients with implantable cardioverter-defibrillators (ICDs) randomly assigned to the QT-prolonging antiarrhythmic dofetilide or placebo. BACKGROUND: Drug-related torsade de pointes (TdP) is usually recognized within days of initiating therapy, but its incidence during long-term therapy is unknown. METHODS: We assessed the frequency of TdP and ICD electrograms compatible with TdP in a multicenter study that randomized ICD patients to placebo (n = 87) or dofetilide (n = 87). As reported elsewhere, the number of patients with a primary trial end point (ICD intervention for VT or ventricular fibrillation) was similar in the two groups. For this analysis, a qualifying event was TdP (on electrocardiogram) or an intracardiac electrogram showing pause-dependent PVT. RESULTS: A total of 620 electrograms obtained in 131 patients were analyzed blindly by prospectively defined criteria for episodes of pause-dependent polymorphic VT. These were identified in 15/87 (17{\%}) patients receiving dofetilide and 5/87 (6{\%}) patients on placebo (p <0.05). Five of these episodes were early (",
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AU - Roden, Dan M.

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