Dronedarone 400 mg twice daily for 12 weeks reduces atrial fibrillation burden in subjects with permanent pacemakers


Dronedarone ( Multaq ) is a benzofuran derivative with a pharmacological profile similar to Amiodarone but has a more rapid onset of action and a much shorter half-life ( 13-19 h ).

Researchers have evaluated the efficacy of Dronedarone in atrial fibrillation ( AF ) patients using dual-chamber pacemakers capable of quantifying atrial fibrillation burden.

Pacemakers were adjusted to optimize atrial fibrillation detection.

Patients with atrial fibrillation burden more than 1 % were randomized to Dronedarone 400 mg twice daily ( BID ) or placebo.
Pacemakers were interrogated after 4 and 12 weeks of treatment.

The primary endpoint was the change in atrial fibrillation burden from baseline over the 12-week treatment period.

Patients with permanent atrial fibrillation, severe / recently decompensated heart failure, and current use of antiarrhythmic drugs were excluded.

From 285 patients screened, 112 were randomized ( mean age 76 years, 60% male, 84% hypertensive, 65% with sick sinus syndrome, 26% with diabetes mellitus type II, 15% with heart failure ).

Baseline mean atrial fibrillation burden was 8.77% for placebo and 10.14% for Dronedarone.

Over the 12-week study period, atrial fibrillation burden compared to baseline decreased by 54.4% ( P = 0.0009 ) with Dronedarone and trended higher by 12.8% ( P = 0.450 ) with placebo.

The absolute change in burden was decreased by 5.5% in the Dronedarone group and increased by 1.1% in the placebo group.

Heart rate during atrial fibrillation was reduced to approximately 4 beats/min with Dronedarone ( P = 0.285 ).

Adverse events were higher with Dronedarone compared to placebo ( 65 vs 56% ).

In conclusion, Dronedarone reduced pacemaker-assessed the relative atrial fibrillation burden compared to baseline and placebo by over 50% during the 12-week observation period. ( Xagena )

Ezekowitz MD et al, J Interv Card Electrophysiol 2015; Epub ahead of print

XagenaMedicine_2015



Indietro

Altri articoli

Available pharmacological options for rhythm control strategy in atrial fibrillation are limited by sub-optimal efficacy and potentially serious adverse events....


Randomized controlled trials ( RCTs ) regarding use of Ranolazine for the prevention and cardioversion of atrial fibrillation have yielded...


Catheter ablation of ventricular tachycardia in patients with nonischemic dilated cardiomyopathy can be challenging because of the complexity of underlying...


The clinical efficacy and toxicity of Amiodarone ( Cordarone ) may be determined more effectively by tissue deposition than by...


Although there are many different antiarrhythmic drugs approved for rhythm management of atrial fibrillation, little comparative effectiveness data exist to...


Amiodarone ( Cordarone ) is known to affect the thyroid, but little is known about thyroid recovery after short-term Amiodarone...


Sotalol ( Sotalex ) and Amiodarone ( Cordarone ) are commonly prescribed antiarrhythmics for the treatment of post-operative atrial fibrillation...


Ibutilide ( Corvert ) is a rapid-acting antiarrhythmic drug with worldwide use for conversion of recent-onset atrial fibrillation. Vernakalant (...


The 2015 Guidelines for Resuscitation recommend Amiodarone ( Cordarone ) as the antiarrhythmic drug of choice in the treatment of...


The European Commission has granted marketing authorization for Epclusa ( Sofosbuvir 400 mg / Velpatasvir 100 mg ), the first...