dofetilide / Generic mfg. - LARVOL DELTA

A Perfect Storm: Dofetilide-Associated Torsades de Pointes (TdP) Managed with Stellate Ganglion Block, VA ECMO, and Cardiac Transplantation (ASA 2026) - "The patient's cardiomyopathy worsened to end-stage. 10 days later, the patient underwent definitive treatment with orthotopic heart transplantation and survived to home discharge."

Aesthetic Medicine • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Transplantation • Ventricular Tachycardia

Turning Yellow on Rhythm Control: Dofetilide and the Unexpected Cholestatic Storm (ACG 2026) - "He had initiated dofetilide and apixaban two months prior for atrial fibrillation management. Clinicians should maintain a high index of suspicion for hepatotoxicity when initiating dofetilide, particularly in elderly populations, to ensure timely drug cessation and favorable clinical outcomes. Figure: Liver biopsy showing focal hepatocellular necrosis in setting of dofetilide induced cholestatic liver injury Figure: Liver biopsy demonstrating prominent canalicular cholestasis"

Atrial Fibrillation • Autoimmune Hepatitis • Cardiovascular • Cholestasis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Pruritus • CYP3A4

Spatial heterogeneity of APD under long QT conditions: characterisation and relationship to sinus activation sequence. (PubMed, Cardiovasc Res) - "Ventricular sites with distinct sinus activation times exhibit different electrophysiological properties which contribute to enhanced spatial heterogeneity of APD under long QT conditions."

Heterogeneity • Journal • Cardiovascular

Safety of Four Doses Compared with Six Doses for Dofetilide Reloading for Treatment of Atrial Arrhythmia (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular

Association of common QT-prolonging medications with arrhythmic risk in patients with bundle branch block: A stratified cohort analysis in left bundle branch block vs. right bundle branch block phenotypes. (PubMed, Heart Lung) - "Common non-cardiac QT-prolonging medications were not associated with increased risk in patients with BBB, even with prolonged QTc. The divergence between composite and sensitivity results for amiodarone highlights the influence of confounding by indication. Medication alerts should incorporate stratification by drug class rather than QTc alone."

Journal • Cardiovascular • CNS Disorders • Congestive Heart Failure • Critical care • Heart Failure

SphereChip attaches spheroids and organoids to planar multielectrode arrays with microfluidics. (PubMed, Lab Chip) - "We observed concentration-dependent prolongation of action and field potentials of cardiospheres by the potassium channel (Kv1.11) inhibitors E4031 and dofetilide...We present these results as proof of concept for the microfluidics device as a means to enable organ-on-a-chip studies combining field potential measurements with simultaneous imaging on spherical cell models using planar MEAs. The method is applicable to different MEA formats and holds promise as a workable platform for drug testing and toxicity studies."

Journal

One-year outcomes of rhythm control strategies for atrial fibrillation among patients with cardiac amyloidosis and heart failure (ESC 2026) - "Objective We compared clinical outcomes between catheter ablation and antiarrhythmic drug therapy for atrial fibrillation in patients with amyloidosis and heart failure Methods We conducted a retrospective cohort study using TriNetX Research Network, identifying 1,541 patients who underwent catheter ablation and 8,677 patients treated with antiarrhythmics (amiodarone, sotalol, dofetilide, dronedarone) for atrial fibrillation with documented amyloidosis and heart failure. Stroke rates were similar (6.9% vs 8.2%, p=0.232). Catheter ablation was associated with higher cardioversion requirements (22.1% vs 14.1%, p<0.001) Conclusion In patients with cardiac amyloidosis, heart failure, and atrial fibrillation, catheter ablation was associated with decreased mortality compared to antiarrhythmic drugs, along with significantly fewer heart failure events and hospitalizations."

Clinical • Atrial Fibrillation • Cardiac Amyloidosis • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction • Ventricular Tachycardia

Non-invasive electrocardiographic imaging of torsades de pointes in an ovine model of drug-induced QT prolongation: recovery dispersion sets the stage, and abnormal impulse formation pulls the trigger (ESC 2026) - "Subsequently, escalating IKr blockade was induced by i.v. dofetilide (N=7/7; up to 21-42 µg/kg), followed by IKs blockade by i.v. HMR1556 (N=4/7; up to 2.25 mg/kg), until spontaneous TdP occurred... Spatiotemporally heterogeneous RT prolongation creates a vulnerable TdP substrate, whereas abnormally activating PVCs act as the immediate trigger for TdP onset, highlighting the translational potential of ECGI for in-vivo investigations of arrhythmogenic mechanisms related to prolonged repolarization."

Non-invasive • Cardiovascular

Safety evaluation of dofetilide administration per enteral tube. (PubMed, HeartRhythm Case Rep) - No abstract available

Journal • Atrial Fibrillation • Cardiovascular

Safety of Dofetilide Initiation Following a Shortened Amiodarone Washout Period. (PubMed, JACC Clin Electrophysiol) - "In this cohort, dofetilide initiation within 90 days of amiodarone discontinuation was not associated with TdP during inpatient loading, supporting the feasibility of monitored, expedited transitions in select patients."

Journal • Atrial Fibrillation • Cardiovascular

Amsacrine modifies action potential configuration without its prolongation via the blockade of multiple ion currents in canine ventricular cells. (PubMed, Biomed Pharmacother) - "It contains methanesulfonamide group -similar to hERG/IKr inhibitors like E-4031 and dofetilide-therefore may exert cardiac arrhythmias...Amsacrine reduced phase 0 parameters: maximal upstroke velocity (∼50-60%), action potential amplitude (∼15%), and peak potential (∼55%), suggesting inhibition of sodium current...The lack of AP prolongation despite IKr inhibition can be due to concomitant suppression of inward currents. As the tested concentrations overlap with therapeutic plasma levels (3-18 µM), amsacrine may carry a non-negligible risk of cardiac electrophysiological effects, particularly in susceptible patients."

Journal • Acute Lymphocytic Leukemia • Cardiovascular • Hematological Malignancies • Leukemia • Oncology • NAV1

Transparent Graphene Interfaces for Capacitive Recordings from hiPSC-Derived Cardiomyocyte Monolayers: A Proof-of-Concept Study. (PubMed, Sensors (Basel)) - "Signal amplitude and waveform morphology varied across sensors, indicating that recording performance depended strongly on the cell-sensor interface, including cell attachment, monolayer integrity, and capacitive coupling at the sensing surface. A descriptive perturbation sequence using the hERG blocker dofetilide revealed changes in waveform morphology and beat timing across sequential recordings...Combining optical pre-assessment with functional capacitive readout may support integrated workflows. Further studies will be needed to differentiate material-, interface-, and recording-related contributions and to establish reliable conditions for reproducible and scalable recordings."

Journal

Effects of Antiarrhythmics on Cardiac Phenotype and Redox Balance in Spontaneously Hypertensive Rats. (PubMed, Int J Mol Sci) - "Male SHRs were treated for 4 weeks with dronedarone, amiodarone, or dofetilide. Treatments decreased HSP70 expression, while increasing SERCA2 expression, particularly in the dofetilide group. Class III antiarrhythmic drugs differentially affect cardiac function, redox balance, calcium handling, and myocardial remodeling in hypertension, which may contribute to their distinct antiarrhythmic and cardioprotective properties."

Journal • Preclinical • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

The present and future of antiarrhythmic drugs. (PubMed, JRSM Cardiovasc Dis) - "Flecainide, propafenone, and dronedarone have demonstrated their reliable efficacy and safety, even in patients with structural heart disease, which should allow clinicians to reduce their reliance on amiodarone. Previous concerns regarding the proarrhythmic risk of dofetilide and ibutilide are currently managed through careful patient selection and adequate QT interval monitoring. Novel targeted AADs are advancing through the development pipeline, of which etripamil and landiolol have already been approved. Other emerging drugs, such as SK channel blockers (AP30663 and AP31969), RyR2 blockers, CaMKII inhibitors, and TASK-1 blockers (doxapram), are aligned with the new paradigm of atrial fibrillation that focuses on triggers and re-entry...Developing concepts such as atrial cardiomyopathy allows clinicians to characterize substrate objectively, in order to assess disease severity and individualize antiarrhythmic treatment. The future of antiarrhythmic therapy will be..."

Journal • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Heart Failure

Comparative effectiveness of existing medical therapy for atrial fibrillation in hypertrophic cardiomyopathy (AF-HCM) (HEART FAILURE 2026) - "Patients were grouped by post-DCCV outpatient therapy: amiodarone, non-amiodarone AADs (sotalol, dofetilide, dronedarone), or non-AAD therapy (e.g., beta-blockers, calcium channel blockers). Short-term AF recurrence on non-ablative therapy is high, regardless of therapeutic strategy. Amiodarone and non-AAD strategies were more frequent in patients with smaller atria and lower prevalence of prior AF compared to non-amiodarone AADs, reflecting use later in disease course. Use of amiodarone as often as non-AADs in earlier AF-HCM may reflect a preference for immediate stabilization, followed by other AADs with fewer long-term side effects, especially in inpatient settings."

HEOR • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Hypertrophic Cardiomyopathy

AI-enhanced approaches for personalized cardiac treatment: insights from ECG data. (PubMed, NPJ Syst Biol Appl) - "Using the public ECG Effects of Dofetilide, Moxifloxacin, Dofetilide+Mexiletine, Dofetilide+Lidocaine and Moxifloxacin+Diltiazem (ECGDMMLD) database, key electrophysiological features were extracted-including heart rate variability (HRV) and standard cardiac intervals (RR, PR, QT, QRS) to train and compare three different classifiers: XGBoost, Random Forest, and a Support Vector Machine (SVM). These results establish that ML models, particularly XGBoost, can accurately decode complex drug-induced cardiac signatures from ECG data. This work is a powerful demonstration of the proof-of-concept of automated and data-driven analytics integration into clinical processes to enhance drug safety and promote personalized medicine."

Journal

ECG Artifact Masquerading as Ventricular Tachycardia During Dofetilide Initiation. (PubMed, JACC Case Rep) - "Identification of telemetry monitoring before and after events of interest can provide valuable insight in differentiating artifact versus arrhythmia in unclear electrocardiograms."

Journal • Cardiovascular • Ventricular Tachycardia

Medication Costs for Dofetilide: Comparison of Insurance Copayments Versus Generic Pricing Through Cost Plus Drug Company. (PubMed, Circulation) - No abstract available

HEOR • Journal • Pricing • Reimbursement • US reimbursement • Atrial Fibrillation • Cardiovascular

ASSESSING THE FEASIBILITY OF ICM-DERIVED QTC MEASUREMENT FOR LONG-TERM ARRHYTHMIA MANAGEMENT (ACC 2026) - " Patients admitted for sotalol or dofetilide initiation from March to August 2025 were enrolled. The presented feasibility study demonstrates that ICM sECGs may have the ability to support long-term QTc monitoring, with a mean absolute error within the accepted interobserver variability of 20 ms, although further work is needed. The SafeBeat platform displayed a promising ability to consistently monitor heart rhythms over several days to months, suggesting its potential to aid in long-term management of AF patients."

Cardiovascular

CONTINUATION VERSUS INTERRUPTION OF MAINTENANCE ANTIARRHYTHMIC THERAPY IN ADULT INTENSIVE CARE UNIT PATIENTS (ACC 2026) - "Background: For patients admitted to an intensive care unit (ICU), there is limited guidance regarding the management of maintenance antiarrhythmic drug (AAD) therapy such as flecainide, propafenone, dofetilide, dronedarone, and sotalol...For patients who developed unstable arrhythmias, acute treatment with direct current cardioversion (DCCV) or pharmacological therapy, such as amiodarone, beta or non-dihydropyridine calcium channel blockers, or digoxin, will be recorded... Research is currently ongoing with the objective of gaining insight to prescribing patterns and clinical outcomes."

Clinical • Cardiovascular • Critical care • Ventricular Tachycardia

CLINICAL CHARACTERISTICS PREDICTIVE OF DOFETILIDE AS A SUCCESSFUL RHYTHM CONTROL STRATEGY FOR ATRIAL FIBRILLATION IN THE MODERN ERA (ACC 2026) - "Higher baseline and maximum QTc predicted inability to complete DFD, while larger atria predicted long-term failure. Still, 87% achieved durable rhythm control. Identifying predictors may optimize patient selection for DFD."

Clinical • Atrial Fibrillation • Cardiovascular

EFFECTIVENESS AND SAFETY OF SOTALOL VERSUS DOFETILIDE IN PATIENTS WITH ATRIAL FIBRILLATION: A COMPARATIVE STUDY (ACC 2026) - "Preliminary findings are expected to provide comparative insights into the safety and effectiveness of sotalol versus dofetilide in patients with atrial fibrillation or atrial flutter."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction

ENHANCING RISK STRATIFICATION IN ATRIAL FIBRILLATION: PREDICTIVE VALUE OF INITIAL QTC PROLONGATION DURING ANTIARRHYTHMIC DRUG THERAPY (ACC 2026) - " We conducted a retrospective study of patients admitted for dofetilide or sotalol loading between July 2022 and April 2023 at a single center. An initial QTc increase >10.5% was the strongest predictor of adverse events during AAD initiation, outperforming traditional risk factors. This novel biomarker may serve as a simple, early indicator of AF patients that may be at higher risk for adverse events, enhancing risk stratification and patient-specific care strategies."

Atrial Fibrillation • Cardiovascular

NAVIGATING THE COMPLEX HEART: PACING SOLUTIONS IN ADULT CONGENITAL HEART DISEASE WITH MECHANICAL TRICUSPID VALVE (ACC 2026) - "Case: A 68-year-old male with prior VSD closure, mechanical TVR, chronic atrial fibrillation/flutter, and recent VF arrest, likely due to renal insufficiency and dofetilide-induced QT prolongation... ACHD patients with mechanical TVR require individualized pacing strategies. Failed CS access warrants imaging to guide re-intervention. Reversible VF may preclude immediate ICD placement."

Clinical • Atrial Fibrillation • Cardiovascular • Heart Failure • Nephrology • Renal Disease

COMPARISON OF SOTALOL AND DOFETILIDE FOR ANTIARRHYTHMIC DRUG LOADING IN PATIENTS WITH ATRIAL FIBRILLATION (ACC 2026) - "Compared to D, S is associated with lower rates of QTc PRO, drug discontinuation or dose reduction, and chemical cardioversion during AAD loading for AF. These findings may affect drug selection for antiarrhythmic drug loading."

Clinical • Atrial Fibrillation • Cardiovascular