Dronedarone for atrial fibrillation have we expanded the antiarrhythmic armamentarium?
Dronedarone is a new antiarrhythmic agent that was recently approved for the prevention of cardiovascular hospitalization driven by atrial fibrillation/flutter. Its approval was based largely on the results of the ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death From Any Cause in Patients With Atrial Fibrillation/Atrial Flutter) trial, which demonstrated a significant 24% reduction in the combined end point of all-cause mortality and cardiovascular hospitalization, primarily driven by the latter. However, several other clinical trials have evaluated the impact of dronedarone on various cardiovascular end points and yielded mixed results. In this article, we summarize the available evidence concerning dronedarone, and offer practical recommendations to health care providers regarding its use in the treatment of atrial fibrillation. We conclude that the available data support the use of dronedarone in select patient populations as a second- or third-line agent.
Singh
David
D
Division of Cardiology, Cedars-Sinai Medical Center, and the David Geffen School of Medicine, University of California, Los Angeles, California 90048 , USA.
Cingolani
Eugenio
E
Diamond
George A
GA
Kaul
Sanjay
S
D000638:Amiodarone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D000077764:Dronedarone; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
D000077764:Dronedarone; D000638:Amiodarone