{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:23:35Z","timestamp":1747185815463,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T00:00:00Z","timestamp":1650153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Dofetilide suppresses atrial fibrillation\u00a0(AF) in a dose\u2010dependent fashion. The protective effect of AF against QT<jats:sub>c<\/jats:sub> prolongation induced <jats:italic>torsades de pointe<\/jats:italic> and transient post\u2010cardioversion QT<jats:sub>c<\/jats:sub> prolongation may result in dofetilide under\u2010dosing during initiation. Thus, the optimal timing of cardioversion for AF patients undergoing dofetilide initiation to optimize discharge dose remains unknown as does the longitudinal stability of QT<jats:sub>c<\/jats:sub>. The purpose of this study was to evaluate the impact of baseline rhythm on dofetilide dosing during initiation and assess the longitudinal stability of QT<jats:sub>c\u2010all<\/jats:sub> (Bazzett, Fridericia, Framingham, and Hodges) over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of patients who underwent preplanned dofetilide loading at a tertiary care center between January 2016 and 2019 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 198 patients (66\u2009\u00b1\u200910 years, 32% female, CHADS<jats:sub>2<\/jats:sub>\u2010Vasc 3 [2\u20134]) presented for dofetilide loading in either AF (59%) or sinus rhythm\u00a0(SR) (41%). Neither presenting rhythm, nor spontaneous conversion to SR impacted discharge dose. The cumulative dofetilide dose before cardioversion moderately correlated (<jats:italic>r<\/jats:italic>\u2009=\u2009.36; <jats:italic>p<\/jats:italic>\u2009=\u2009.0001) with discharge dose. Postcardioversion QT<jats:sub>c\u2010all<\/jats:sub> prolongation (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) prompted discharge dose reduction (890\u2009\u00b1\u2009224\u2009mcg vs. 552\u2009\u00b1\u2009199\u2009mcg; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) in 30% patients. QT<jats:sub>c\u2010all<\/jats:sub> in SR prolonged significantly during loading (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). All patients displayed QT<jats:sub>c\u2010all<\/jats:sub> reduction (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) from discharge to short\u2010term (46 [34\u201365] days) that continued at long\u2010term (360 [296\u2013414] days) follow\u2010ups. The extent of QT<jats:sub>c\u2010all<\/jats:sub> reduction over time moderately correlated with discharge QT<jats:sub>c\u2010all<\/jats:sub> (<jats:italic>r<\/jats:italic>\u2009=\u2009.54\u20130.65; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dofetilide initiation before cardioversion is equivalent to initiation during SR. Significant QT<jats:sub>c<\/jats:sub> reduction proportional to discharge QT<jats:sub>c<\/jats:sub> is seen over time in all dofetilide\u2010treated patients. QT<jats:sub>c<\/jats:sub> returns to preloading baseline during follow\u2010up in patients initiated in SR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15483","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T08:05:57Z","timestamp":1648800357000},"page":"1281-1289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal QT<sub>c<\/sub> stability and impact of baseline cardiac rhythm on discharge dose in dofetilide\u2010treated patients"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4301-7323","authenticated-orcid":false,"given":"Zeryab A.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine OhioHealth Doctors Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan E.","family":"LaBreck","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Riverside Methodist Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Luli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine OhioHealth Doctors Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Riverside Methodist Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Riverside Methodist Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rayan","family":"El\u2010Zein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine OhioHealth Doctors Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaret D.","family":"Tyler","sequence":"additional","affiliation":[{"name":"Department of Cardiology, OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital Section of Cardiac Electrophysiology  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene Y.","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital Section of Cardiac Electrophysiology  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sreedhar R.","family":"Billakanty","sequence":"additional","affiliation":[{"name":"Department of Cardiology, OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital Section of Cardiac Electrophysiology  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anish K.","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, OhioHealth Heart and 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