Current Treatment Options in Cardiovascular Medicine

, Volume 15, Issue 4, pp 467–475

Appropriate and Inappropriate Use of Dronedarone in 2013

Arrhythmia (B Stambler, Section Editor)

DOI: 10.1007/s11936-013-0246-5

Cite this article as:
Naccarelli, G.V. Curr Treat Options Cardio Med (2013) 15: 467. doi:10.1007/s11936-013-0246-5

Opinion statement

Dronedarone is a multichannel blocking antiarrhythmic agent that has been shown to prevent atrial fibrillation/flutter (AF/AFl) recurrences in several multi-center trials. In the ANDROMEDA trial, dronedarone treatment increased mortality and cardiovascular hospitalizations patients with decompensated heart failure. In the ATHENA trial, dronedarone was used in elderly high risk patients with paroxysmal or persistent AF/AFl, excluding those with advanced heart failure, cardiovascular hospitalizations were significantly reduced. Dronedarone increased mortality and cardiovascular hospitalizations in a different patient group with permanent AF/AFl. Although organic toxicity from the drug is very rare, post-marketing data has reported rare hepatic toxicity associated with dronedarone use. Current guidelines position dronedarone as a front-line antiarrhythmic in many patients with AF/Fl. However, dronedarone should not be used in patients with advanced heart failure or in permanent AF. Clinical trial results have helped us define appropriate and inappropriate candidates for dronedarone.


DronedaroneAtrial fibrillationAppropriate vs inappropriateATHENA trialANDROMEDA trial

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Penn State Hershey Heart & Vascular Institute, Cardiac Electrophysiology ProgramPenn State University College of MedicineHersheyUSA