Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter
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 modifications reduced thyroid and other end-organ adverse effects and makes dronedarone less lipophilic, shortening its half-life. Dronedar...
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doaj-378d38067b884b56990c2b113bfad6472020-11-25T03:43:31ZengSAGE PublishingClinical Medicine Insights: Cardiology1179-54682011-01-01510.4137/CMC.S6677Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/FlutterGerald V. Naccarelli0Deborah L. Wolbrette1Vadim Levin2Soraya Samii3Javier E. Banchs4Erica Penny-Peterson5Mario D. Gonzalez6Penn State Hershey Heart and Vascular Institute, Cardiac Electrophysiology Program, Hershey, PA, USA.Penn State Hershey Heart and Vascular Institute, Cardiac Electrophysiology Program, Hershey, PA, USA.Lehigh Valley Hospital Electrophysiology Laboratory Allentown, PA, USA.Penn State Hershey Heart and Vascular Institute, Cardiac Electrophysiology Program, Hershey, PA, USA.Penn State Hershey Heart and Vascular Institute, Cardiac Electrophysiology Program, Hershey, PA, USA.Penn State Hershey Heart and Vascular Institute, Cardiac Electrophysiology Program, Hershey, PA, USA.Penn State Hershey Heart and Vascular Institute, Cardiac Electrophysiology Program, Hershey, PA, USA.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 modifications reduced thyroid and other end-organ adverse effects and makes dronedarone less lipophilic, shortening its half-life. Dronedarone has been shown to prevent atrial fibrillation/flutter (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 significantly 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.https://doi.org/10.4137/CMC.S6677 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gerald V. Naccarelli Deborah L. Wolbrette Vadim Levin Soraya Samii Javier E. Banchs Erica Penny-Peterson Mario D. Gonzalez |
spellingShingle |
Gerald V. Naccarelli Deborah L. Wolbrette Vadim Levin Soraya Samii Javier E. Banchs Erica Penny-Peterson Mario D. Gonzalez Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter Clinical Medicine Insights: Cardiology |
author_facet |
Gerald V. Naccarelli Deborah L. Wolbrette Vadim Levin Soraya Samii Javier E. Banchs Erica Penny-Peterson Mario D. Gonzalez |
author_sort |
Gerald V. Naccarelli |
title |
Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter |
title_short |
Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter |
title_full |
Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter |
title_fullStr |
Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter |
title_full_unstemmed |
Safety and Efficacy of Dronedarone in the Treatment of Atrial Fibrillation/Flutter |
title_sort |
safety and efficacy of dronedarone in the treatment of atrial fibrillation/flutter |
publisher |
SAGE Publishing |
series |
Clinical Medicine Insights: Cardiology |
issn |
1179-5468 |
publishDate |
2011-01-01 |
description |
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 modifications reduced thyroid and other end-organ adverse effects and makes dronedarone less lipophilic, shortening its half-life. Dronedarone has been shown to prevent atrial fibrillation/flutter (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 significantly 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. |
url |
https://doi.org/10.4137/CMC.S6677 |
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