title: [Appropriateness criteria for the treatment of atrial fibrillation with dronedarone: practical issues. An Italian cardiologists' expert opinion].
abstract: Antiarrhythmic agents are among the therapeutic options available for the treatment of atrial fibrillation when a rhythm control strategy is required. Although their efficacy seems to be generally comparable to that of nonpharmacological interventions, the use of these agents remains controversial. In particular, among this class of drugs, the use of dronedarone in clinical practice is a matter of debate. In this paper, the authors aimed to address these issues, involving a team of expert cardiologists who discussed about the potential use of dronedarone in different clinical scenarios. The RAND/UCLA appropriateness method was used to develop appropriateness measures for the optimal management of patients treated with dronedarone, by combining the best available scientific evidence with the collective judgment of experts. To this purpose, a group of experts was identified and asked to rate the benefit-to-harm ratio of 52 clinical scenarios. Each indication was classified as "appropriate", "uncertain" or "inappropriate" in accordance with the panelists' median score. The classification of each scenario has led to the development of several recommendations for clinical practice. The use of dronedarone for the management of paroxysmal and persistent atrial fibrillation has evolved over time: this antiarrhythmic drug appears to be useful not only in monitoring symptoms, but also in reducing hospitalization and mortality rates in patients with atrial fibrillation.
authors: Giovanni Luca
authors: GL
authors: Botto
authors: Alessandro
authors: A
authors: Capucci
authors: Antonio
authors: A
authors: Raviele
authors: Giuseppe
authors: G
authors: Boriani
authors: Michele
authors: M
authors: Brignole
authors: Leonardo
authors: L
authors: Calò
authors: Valeria
authors: V
authors: Calvi
authors: Roberto
authors: R
authors: De Ponti
authors: Antonio
authors: A
authors: De Simone
authors: Pietro
authors: P
authors: Delise
authors: Matteo
authors: M
authors: Di Biase
authors: Federico
authors: F
authors: Lombardi
authors: Maurizio
authors: M
authors: Lunati
authors: Maurizio
authors: M
authors: Santomauro
authors: Michele
authors: M
authors: Senni
authors: Giuseppe
authors: G
authors: Stabile
authors: Sakis
authors: S
authors: Themistoclakis
authors: Massimo
authors: M
authors: Tritto
authors: Massimo
authors: M
authors: Volpe
mesh_terms: D000638:Amiodarone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D000077764:Dronedarone; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000077764:Dronedarone; D000638:Amiodarone