TY - JOUR
T1 - Safety and efficacy of dronedarone in the treatment of atrial fibrillation/flutter
AU - Naccarelli, Gerald V.
AU - Wolbrette, Deborah L.
AU - Levin, Vadim
AU - Samii, Soraya
AU - Banchs, Javier E.
AU - Penny-Peterson, Erica
AU - Gonzalez, Mario D.
PY - 2011
Y1 - 2011
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84855287667&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855287667&partnerID=8YFLogxK
U2 - 10.4137/CMC.S6677
DO - 10.4137/CMC.S6677
M3 - Review article
C2 - 22084608
AN - SCOPUS:84855287667
SN - 1179-5468
VL - 5
SP - 103
EP - 119
JO - Clinical Medicine Insights: Cardiology
JF - Clinical Medicine Insights: Cardiology
M1 - 3
ER -