Abstract 15444: Sex Differences in Response to Chemical Cardioversion of Atrial Fibrillation by Dofetilide; a Retrospective Cohort of 160 Persistent Atrial Fibrillation Patients
Introduction: Dofetilide is class 3 antiarrhythmic drug which is FDA approved for persistent AF patients. Studies have shown sex based differences in response to treatment of atrial fibrillation (AF) by anti-arrhythmic drugs. Impact of dofetilide on successful cardioversion of AF by sex has not been well studied.
Methods: We retrospectively analyzed 160 (mean age 63.3±11.6, 26.2% women) AF patients who were started on dofetilide and were followed for 1 year. We examined relationship of sex to failure to cardiovert in multivariable logistic regression model adjusted for age, race, hypertension, diabetes, dyslipidemia, coronary artery disease, smoking, ejection fraction, dose, creatinine and BMI. We examined association of sex with AF related readmission in Cox proportional hazard models adjusted for same covariates
Results: Out of 160 patients, 42 (26.2%) were women. Out of 42 women, 9 (21%) did not convert after 10 consecutive doses of dofetilide as compared to 11 men (9.3%) who did not convert. Out of those who converted, 5 (15%) women compared with 8 (7.5%) men were readmitted with AF during 1 year follow- up. In multivariable adjusted analysis, women were at higher risk of not converting on dofetilide than men (OR 3.92; 95% CI 1.12-13.7, p=0.03). Similarly, there was higher risk of 1-year AF related readmission for women than men (HR 3.60; 95% CI 1.11-11.76, p=0.03).
Conclusions: We observed that men were more likely to achieve sinus rhythm in the short term treatment with Dofetilide. Men were also shown to have less readmissions within 1 year of treatment with Dofetilide. This association needs to be validated in larger studies to devise sex appropriate therapies for AF.
Author Disclosures: H. Hassan: None. W. Qureshi: None. S. Arora: None. P. Akhrass: None. N. Souvaliotis: None. E. Aziz: None.
- © 2016 by American Heart Association, Inc.