Dofetilide

[mbhakta]

Hi wish you all happy and healthy new year!

Is dofetilide is most effective medicine for afib or flutter and keep nsr for years? Perhaps yet it's availability is in few countries other than US. Please share information about treatment of afib or flutter with this medicine. Thanks

[mjames1]

It seems to be a popular choice now in the United States, but my understanding is that it's not available in the UK so you may not get too many responses here, with many members UK based. I'm from the US, but for some reason my ep did not suggest it-- perhaps because it required an initial hospital stay??? -- but rather put me on Flecainide, which has been very effective.

Jim

[mbhakta in reply to mjames1]

Thanks mjames1

[jim-business]

My wife and I are both on Tikosyn (Dofetilide). She got a fib during the pandemic she had a cardioversion that didn't last. She was admitted to the hospital they worked on her electrolytes gave her Tikosyn the next morning she was in nsr. You have to be admitted before taking this drug. A cardioversion wasn't necessary. She has been on it for two years. Her 250 micrograms me 500. Dosage is twice daily you can't miss doses. Twelve hours apart. Keeps heart rate normal as well for us. Best Regards,

Jum

[mav7 in reply to jim-business]

Thanks for sharing your story, jim !

May I ask were you and your wife in permanent, persistent (1 year or less) or paroxsymal afib ? I am in permanent and considering other medications besides rate control (Metoprolol),

[jim-business in reply to mav7]

I was first to acquire afin . w/tachycardia.in 2018 at 77 went to er Dr. gave me a bag of Cardizem talked to my gp, gave me a prescription for oral Cardizem, prefilled syringes of Lovenox, warfarin. Stayed nsr. For a year then diagnosed with bad mitral valve. The put me on large doses of amiodorone for a year almost died from the side effects was taking large doses metropolol. Stopped taking everything except lasix and warfarin which I tested at home thu Biotel. It took 5 mos. for the Amiodorone to leave my body. ( I forgot to tell you I hàd a cardioversion before amiodorone.). I was good for 4 years until I had a serious accident. Then persistent afib./tachycardia. In the meantime my wife had contracted COVID which left her with persistent afib. She had a cardioversion which didn't last. Her cardiologist did the requisite admission which is required to administer Tikosyn/ Dofetilide 250 micrograms. When she woke the next. Morning she was nsr and has been for 2yrs. I had the same treatment and have infrequent bouts of a fib and atopic beats. No high blood pressure or tachycardia. I take 500 micrograms of Tikosyn twice a day vitamin d3 lasix 1.- 25mg metropolol er and zanaax as needed for anxiety.Ask your Dr if Tikosyn is right for you. It has to be started in the cardiac unit at the hospital monitored for at least 3 days

Best Regards,

Jim

[mav7 in reply to jim-business]

Thanks for the reply.

[mbhakta]

Thanks Jum

[Snowgirl65]

I was on Dofetilide for a while after Flecainide stopped working. I had no problem with the drug, except that I had to stay in the hospital for 3 days while dosage was adjusted.

[mbhakta in reply to Snowgirl65]

Thanks Snowgirl65

[lovetogarden in reply to Snowgirl65]

I had a similar experience, went on it after Sotalol stopped working. Eventually dofetilide stopped working too. Now on dronedarone.

[mav7 in reply to lovetogarden]

Thanks for sharing, ltg. May I ask did Sotalol and Dofetilide return you to NSR for a period before they stopped working ? How is dronedarone doing ? And are you in paroxsymal afib, persistent, or permanent. Thanks ! I am on rate control (Metoprolol) but considering other options.

[lovetogarden in reply to mav7]

All of the drugs worked ok for a while. 3 ablations managed to finally banish my afib. But they couldn’t ablate my atrial tachycardia. All the meds have helped keep the tachycardia stay at a lower heart rate and control the frequency, but I still get short bouts several times a week. Hoping that an ablation with the new pulsed field technology will deal with the tachycardia, but not yet widely available in the U.S.

[mbhakta in reply to lovetogarden]

Thanks lovetogarden

[frazeej]

I have been told by my cardioguy (U.S.) that dofetilide requires a 3 day hospital stay to uptitrate the dosage, and you must be in NSR when beginning. It is also the only anti-arrythmic recommended for those that have an "imperfect" heart, namely those with heart damage from CHD or MI's. While you can remain on it long term, it, like others can lose effectiveness over time. Is it the best? The best is whatever works!

[mbhakta in reply to frazeej]

Thanks frazeej

[kocoach]

I was on dofetelide (tikosyn) for twenty plus years after being on a trial of it for approval of use for afib and it was very good except for an occasional breakthrough . I was able to do daily heavy work out's including running in sand, sparring etc,etc. The main thing I had to watch out for was other medication interactions of which there was quite a lot. Other than that it worked very well for me but it eventually lost it's effectiveness and had I to go on amiodarone which I am presently on. You will have to spend three day's in the Hospital when they first administer it to you so they can monitor how it's working for you. Good Luck and Hope it works for you as good as it did for me !!!!

[mbhakta in reply to kocoach]

Thanks kocoach

[hartbeast]

My EP is recommending dofetilide now - flecainide worked for three years after the positive effects of a 2018 cryo-ablation wore off in 2020. I then had a pulse field ablation June 2024 and am one of the very few people having a rapid relapse among hundreds of succesful PFAs my EP has done since April. Helpful to hear others' stories. Nervous about trying the dofetilide after having such a terrible time with amiodarone at the beginning of this wild ride...