Outpatient initiation of dofetilide: insights from the complexities of atrial fibrillation management during the COVID-19 lockdown.
Identifieur interne : 000257 ( Main/Exploration ); précédent : 000256; suivant : 000258Outpatient initiation of dofetilide: insights from the complexities of atrial fibrillation management during the COVID-19 lockdown.
Auteurs : Daniel A N. Mascarenhas [États-Unis] ; Praveen C. Mudumbi [États-Unis] ; Bharat K. Kantharia [États-Unis]Source :
- Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [ 1572-8595 ] ; 2021.
Abstract
BACKGROUND
At peak COVID-19 lockdown, patients with symptomatic atrial fibrillation (AF) were faced with an equipoise between a palliative rate-control versus cautious rhythm-control strategy, including hospitalization for initiation of antiarrhythmic drug/s (AADs) and cardiac procedures which was impossible due to hospitalization restrictions.
OBJECTIVES
We aimed to evaluate the efficacy and safety of outpatient initiation of dofetilide in patients with AF using cardiac implantable electronic devices (CIEDs) for rhythm and QTc interval monitoring.
METHODS
Adult patients with symptomatic AF with prior failure or intolerance to other AADs were enrolled if they were willing to in-office insertion of implantable loop recorders or already implanted with pacemakers or defibrillators capable of remote monitoring. Exclusion criteria were known medical contraindications of dofetilide and unable to provide consent. After making a shared management decision, dofetilide was initiated in a physician office, and rhythm and QTc intervals were monitored by ECGs and CIEDs. Patients were followed to assess the efficacy and safety of the treatment.
RESULTS
The study cohort comprised of 30 patients, age 76 ± 7 years (mean ± standard deviation), 10 female (33%), CHA
CONCLUSION
Effective and safe outpatient initiation of dofetilide during the extenuating circumstance of COVID-19 lockdown was possible in patients with AF who had CIEDs.
DOI: 10.1007/s10840-021-00942-y
PubMed: 33484394
PubMed Central: PMC7823191
Affiliations:
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Mudumbi</name><affiliation wicri:level="1"><nlm:affiliation>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023</wicri:regionArea><wicri:noRegion>10023</wicri:noRegion></affiliation></author><author><name sortKey="Kantharia, Bharat K" sort="Kantharia, Bharat K" uniqKey="Kantharia B" first="Bharat K" last="Kantharia">Bharat K. Kantharia</name><affiliation wicri:level="1"><nlm:affiliation>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023, USA. bkantharia@yahoo.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023</wicri:regionArea><wicri:noRegion>10023</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Icahn School of Medicine at Mount Sinai, New York, NY, USA. bkantharia@yahoo.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Icahn School of Medicine at Mount Sinai, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33484394</idno><idno type="pmid">33484394</idno><idno type="doi">10.1007/s10840-021-00942-y</idno><idno type="pmc">PMC7823191</idno><idno type="wicri:Area/Main/Corpus">000098</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000098</idno><idno type="wicri:Area/Main/Curation">000098</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000098</idno><idno type="wicri:Area/Main/Exploration">000098</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Outpatient initiation of dofetilide: insights from the complexities of atrial fibrillation management during the COVID-19 lockdown.</title><author><name sortKey="Mascarenhas, Daniel A N" sort="Mascarenhas, Daniel A N" uniqKey="Mascarenhas D" first="Daniel A N" last="Mascarenhas">Daniel A N. Mascarenhas</name><affiliation wicri:level="2"><nlm:affiliation>Drexel University College of Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Drexel University College of Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Mudumbi, Praveen C" sort="Mudumbi, Praveen C" uniqKey="Mudumbi P" first="Praveen C" last="Mudumbi">Praveen C. Mudumbi</name><affiliation wicri:level="1"><nlm:affiliation>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023</wicri:regionArea><wicri:noRegion>10023</wicri:noRegion></affiliation></author><author><name sortKey="Kantharia, Bharat K" sort="Kantharia, Bharat K" uniqKey="Kantharia B" first="Bharat K" last="Kantharia">Bharat K. Kantharia</name><affiliation wicri:level="1"><nlm:affiliation>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023, USA. bkantharia@yahoo.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023</wicri:regionArea><wicri:noRegion>10023</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:affiliation>Icahn School of Medicine at Mount Sinai, New York, NY, USA. bkantharia@yahoo.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Icahn School of Medicine at Mount Sinai, New York, NY</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j">Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing</title><idno type="eISSN">1572-8595</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>At peak COVID-19 lockdown, patients with symptomatic atrial fibrillation (AF) were faced with an equipoise between a palliative rate-control versus cautious rhythm-control strategy, including hospitalization for initiation of antiarrhythmic drug/s (AADs) and cardiac procedures which was impossible due to hospitalization restrictions.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>We aimed to evaluate the efficacy and safety of outpatient initiation of dofetilide in patients with AF using cardiac implantable electronic devices (CIEDs) for rhythm and QTc interval monitoring.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Adult patients with symptomatic AF with prior failure or intolerance to other AADs were enrolled if they were willing to in-office insertion of implantable loop recorders or already implanted with pacemakers or defibrillators capable of remote monitoring. Exclusion criteria were known medical contraindications of dofetilide and unable to provide consent. After making a shared management decision, dofetilide was initiated in a physician office, and rhythm and QTc intervals were monitored by ECGs and CIEDs. Patients were followed to assess the efficacy and safety of the treatment.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The study cohort comprised of 30 patients, age 76 ± 7 years (mean ± standard deviation), 10 female (33%), CHA</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Effective and safe outpatient initiation of dofetilide during the extenuating circumstance of COVID-19 lockdown was possible in patients with AF who had CIEDs.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33484394</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1572-8595</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jan</Month><Day>23</Day></PubDate></JournalIssue><Title>Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing</Title><ISOAbbreviation>J Interv Card Electrophysiol</ISOAbbreviation></Journal><ArticleTitle>Outpatient initiation of dofetilide: insights from the complexities of atrial fibrillation management during the COVID-19 lockdown.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1007/s10840-021-00942-y</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">At peak COVID-19 lockdown, patients with symptomatic atrial fibrillation (AF) were faced with an equipoise between a palliative rate-control versus cautious rhythm-control strategy, including hospitalization for initiation of antiarrhythmic drug/s (AADs) and cardiac procedures which was impossible due to hospitalization restrictions.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">We aimed to evaluate the efficacy and safety of outpatient initiation of dofetilide in patients with AF using cardiac implantable electronic devices (CIEDs) for rhythm and QTc interval monitoring.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Adult patients with symptomatic AF with prior failure or intolerance to other AADs were enrolled if they were willing to in-office insertion of implantable loop recorders or already implanted with pacemakers or defibrillators capable of remote monitoring. Exclusion criteria were known medical contraindications of dofetilide and unable to provide consent. After making a shared management decision, dofetilide was initiated in a physician office, and rhythm and QTc intervals were monitored by ECGs and CIEDs. Patients were followed to assess the efficacy and safety of the treatment.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The study cohort comprised of 30 patients, age 76 ± 7 years (mean ± standard deviation), 10 female (33%), CHA<sub>2</sub>DS<sub>2</sub>-VASc score 3.25 ± 1.3, ejection fraction 63.45% ± 8.52, and QTc interval 431.68 ± 45.09 ms. From 22 (73%) patients in AF at presentation, SR was restored in 14 (64%) patients after 4 doses of dofetilide. At 46 ± 59 days of follow-up, maintenance of SR in total 22 (73%) patients without cardiac adverse effects was accomplished.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Effective and safe outpatient initiation of dofetilide during the extenuating circumstance of COVID-19 lockdown was possible in patients with AF who had CIEDs.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mascarenhas</LastName><ForeName>Daniel A N</ForeName><Initials>DAN</Initials><AffiliationInfo><Affiliation>Drexel University College of Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mudumbi</LastName><ForeName>Praveen C</ForeName><Initials>PC</Initials><AffiliationInfo><Affiliation>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kantharia</LastName><ForeName>Bharat K</ForeName><Initials>BK</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-4207-0387</Identifier><AffiliationInfo><Affiliation>Cardiovascular and Heart Rhythm Consultants, 30 West 60th Street, Suite 1U, New York, NY, 10023, USA. bkantharia@yahoo.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Icahn School of Medicine at Mount Sinai, New York, NY, USA. bkantharia@yahoo.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>01</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Interv Card Electrophysiol</MedlineTA><NlmUniqueID>9708966</NlmUniqueID><ISSNLinking>1383-875X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Antiarrhythmic drugs</Keyword><Keyword MajorTopicYN="N">Atrial fibrillation</Keyword><Keyword MajorTopicYN="N">CIED</Keyword><Keyword MajorTopicYN="N">COVID-19 lockdown</Keyword><Keyword MajorTopicYN="N">Dofetilide</Keyword><Keyword MajorTopicYN="N">Remote monitoring</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2 corona virus</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>11</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>01</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>1</Month><Day>23</Day><Hour>12</Hour><Minute>6</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>1</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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sortKey="Mascarenhas, Daniel A N" sort="Mascarenhas, Daniel A N" uniqKey="Mascarenhas D" first="Daniel A N" last="Mascarenhas">Daniel A N. Mascarenhas</name></region><name sortKey="Kantharia, Bharat K" sort="Kantharia, Bharat K" uniqKey="Kantharia B" first="Bharat K" last="Kantharia">Bharat K. Kantharia</name><name sortKey="Kantharia, Bharat K" sort="Kantharia, Bharat K" uniqKey="Kantharia B" first="Bharat K" last="Kantharia">Bharat K. Kantharia</name><name sortKey="Mudumbi, Praveen C" sort="Mudumbi, Praveen C" uniqKey="Mudumbi P" first="Praveen C" last="Mudumbi">Praveen C. Mudumbi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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