Safety and efficacy of dronedarone in the treatment of atrial fibrillation/flutter

Gerald V. Naccarelli, Deborah L. Wolbrette, Vadim Levin, Soraya Samii, Javier E. Banchs, Erica Penny-Peterson, Mario D. Gonzalez

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

Dronedarone is an amiodarone analog but differs structurally from amiodarone in that the iodine moiety was removed and a methane-sulfonyl group was added. These modifcations reduced thyroid and other end-organ adverse effects and makes dronedarone less lipophilic, shortening its half-life. Dronedarone has been shown to prevent atrial fbrillation/futter (AF/AFl) recurrences in several multi-center trials. In addition to its rhythm control properties, dronedarone has rate control properties and slows the ventricular response during AF. Dronedarone is approved in Europe for rhythm and rate control indications. In patients with decompensated heart failure, dronedarone treatment increased mortality and cardiovascular hospitalizations. However, when dronedarone was used in elderly high risk AF/AFl patients excluding such high risk heart failure, cardiovascular hospitalizations were signifcantly reduced and the drug was approved in the USA for this indication in 2009 by the Food and Drug Administration. Updated guidelines suggest dronedarone as a front-line antiarrhythmic in many patients with AF/Fl but caution that the drug should not be used in patients with advanced heart failure. In addition, the recent results of the PALLAS trial suggest that dronedarone should not be used in the long-term treatment of patients with permanent AF.

Original languageEnglish (US)
Article number3
Pages (from-to)103-119
Number of pages17
JournalClinical Medicine Insights: Cardiology
Volume5
DOIs
Publication statusPublished - Jan 1 2011

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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