Post-ATHENA and beyond

Dronedarone, an amiodarone analog, was developed to be a safer alternative to amiodarone. Dronedarone is useful in suppressing atrial fibrillation/flutter and controlling the ventricular response. Dronedarone reduced cardiovascular hospitalization in the ATHENA trial (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). This paper reviews the results of ATHENA, including subsequent sub-analyses of the trial. These results raise the hypothesis that many of the benefits noted from this trial may be secondary to more than the antiarrhythmic properties of dronedarone. Future studies will clarify the mechanisms of this beneficial effect.