Newer Class III Anti-arrhythmic drug: dofetilide
Jim Powell
from 30 to 45% I'm still in afib unless on medication.
I've started to do some reading on this drug as my cardiologist just
took me off amiodarone after a 14 months. I came off the amiodarone
because I couldn't get down to what was considered a safer maintenance
dose -- it took 300-400 mg a day to keep me in sinus rhythm and that
was about 80% of the time even at that dose I was going into afib at
night about every three days (but I'd come out of it quickly after
getting up in the morning). He felt that it wasn't worth the risk
continuing at that dose.
So now, I stopped taking the amiodarone about 10 days ago and I'm in
full-time afib. I feel like crap.
anyway, my question is this -- does anyone have info on dofetilide as
an alternative to amiodarone? I've read a couple articles including
http://www.cardiologyline.net/stories/storyReader$408 that seemed to
indicate it was effective.
I had mentioned the drug to my cardio in Hawaii (where I live) and he
didn't seem to interested in it. I'm working in California no a long
term project and now have additional medical insurance where I can go
somewhere other than my HMO. I think the drug might still be in
trials and I'd like to see if I could get in one. I work in Silicon
Valley near Stanford and I thought perhaps I could find a doctor
there?
Any input on dofetilide would be appreciated.
Thanks,
Jim
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2 or 4 people there are on that new drug.
tino
David N Wiggins
should you use any of the info in the following message without
consulting with your physician first. Since you state that you have
recently come off of amiodarone and are now in full-time afib, you need
to speak with a physician immediately anyways.
Amiodarone and dofetilide (as well as sotalol) are Class III
antiarrhythmic agents. In order of strength, and in the order which we
give these drugs to patients, amiodarone is first, followed by sotalol,
and then, if necessary, dofetilide. Dofetilide is the strongest of the
three, but that strength comes with a price: if you fibrillate (vfib,
not afib) while on it, the chances of being resuscitated are very slim
(for the record I have NEVER seen anyone on dofetilide fibrillate and
live to tell about it). All three drugs can cause you to fibrillate;
the stronger the drug, the higher the chance that you will fibrillate;
the stronger the drug, the lower the chance that you will survive the
fibrillation.
Your doc took you off of amiodarone because your daily dose wasn't
keeping you out of afib; that high a dose is also likely to cause you to
fibrillate (vfib) (your post was intelligent and I'm sure you know this,
but in case you don't, when you fibrillate, you pass out and die, unless
someone can shock you in time). Generally speaking, the only reason
docs put patients on these meds is that the benefit (keeping you out of
afib) outweighs the risk (fibrillating and dying). Since it wasn't
keeping you out of afib, it wasn't worth the risk.
Dofetilide is a relatively new drug. There is some, but not a lot of
literature on it. If you understand the risk of death associated with
it, and still want to take it, I would suggest talking to a cardiologist
who specializes in Cardiac Electrophysiology. He might even be able to
fix your problem without these meds (eg, RF Ablation).
On a more urgent note, you are in full time afib and taking no control
medication. Has your doctor explained the risk of pulmonary
embolization and/or stroke you now face? You need to get to a doctor
NOW, get your heart under control, and get on with life. Hope I've
helped.
Jim Powell
As for my afib, I've been on warfain (plus ACE inhibitors,
Betablockers and a mild dirueretic) for going on 2 years.
Some of the literature I've read about dofetilide put a risk of vfib
at somewhere between 1 and 3%... that seems a bit high for my liking,
but I'll be going in to talk to the EP's at Stanford University
Hospital next week (my first visit -- I just got new insurance and was
on a Kaiser HMO).
Thanks for the feedback. Hearing this, I'm not real hurry to see how
I fare with statistics!
Jim
On Fri, 10 Nov 2000 07:34:12 GMT, David N Wiggins <dwig...@home.com>
wrote:
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James D
David N Wiggins <dwig...@home.com> wrote in message
news:3A0BB30A...@home.com...
> Disclaimer: The following is an opinion, not medical advice. In no way
> should you use any of the info in the following message without
> consulting with your physician first. Since you state that you have
> recently come off of amiodarone and are now in full-time afib, you need
> to speak with a physician immediately anyways.
>
> Amiodarone and dofetilide (as well as sotalol) are Class III
> antiarrhythmic agents. In order of strength, and in the order which we
> give these drugs to patients, amiodarone is first, followed by sotalol,
> and then, if necessary, dofetilide.
I was given sotalol, and tried a couple of other drugs, before I tried
amiodarone. As I understand it amiodarone is more effective but also much
more toxic than sotalol. (I'm a 31 male in UK had PAF for 2 years).
--
James D
AFibbers Database http://www.dialsolutions.com/af
AFib Suport Group http://www.egroups.com/group/AFIBsupport
Wyle Coyote
this i had or have had the same symtoms as you wrote in your letter and im
takin stuff called Toprol and Tiazac for my a-fib it works for the most
part, again i`d listen to David by the way i know what you mean when you
say you feel like "crap" so keep your chin up were not alone...
a-fibbing in
brooklyn
Jim Powell wrote:
Wyle Coyote
this i had or have had the same symtoms as you wrote in your letter and im
takin stuff called Toprol and Tiazac for my a-fib it works for the most
part, again i`d listen to David by the way i know what you mean when you
say you feel like "crap" so keep your chin up were not alone...
Jim Powell wrote: