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Appropriate and Inappropriate Use of Dronedarone in 2013

  • Arrhythmia (B Stambler, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

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.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Conflict of Interest

Dr. Gerald Naccarelli reported receiving consultancy, honoraria, and payment for the development of educational presentations including service on speakers’ bureaus from Sanofi.

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  1. Penn State Hershey Heart & Vascular Institute, Cardiac Electrophysiology Program, Penn State University College of Medicine, 500 University Drive, Room H1511, Hershey, PA, 17033, USA

    Gerald V. Naccarelli MD

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  1. Gerald V. Naccarelli MD
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Correspondence to Gerald V. Naccarelli MD.

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Naccarelli, G.V. Appropriate and Inappropriate Use of Dronedarone in 2013. Curr Treat Options Cardio Med 15, 467–475 (2013). https://doi.org/10.1007/s11936-013-0246-5

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  • DOI: https://doi.org/10.1007/s11936-013-0246-5

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