Real-World Observations with Dronedarone Compared to Other Anti-Arrhythmic Drugs in Recurrent Atrial Fibrillation

Background: Many clinical trials have shown that dronedarone which is a potent ion channels blocker is effective in the prevention of atrial fibrillation (AF) relapses.
Objective: The aim of this report is to evaluate the recurrence of AF and safety during therapy with dronedarone.
Methods: From September 2010 to February 2013, 95 patients with recurrent AF were followed by our department. The mean age was 71. Fifty-two were male (55%). All patients were in class NHYA I-II with paroxysmal or persistent AF. Hepatic enzymes were controlled after 1, 3, and 6 months of therapy.
Results: Structural heart diseases were present in 90.5% of patients; 9.5% of patients had lone AF. We observed recurrences of AF in 37.9% of patients treated with dronedarone compared with 39% of patients treated with propafenone or flecainide, 35% of patients treated with sotalol and 25% of patients treated with amiodarone. Using log-rank Mantel-Cox test there are no statistical significant differences between dronedarone and IC anti-arrhythmic drugs and sotalol (p 0.743; p 0.868).
Conclusion: According to guidelines, dronedarone resulted as effective as other anti-arrhythmic drugs (except amiodarone) in the prevention of AF with the advantage that it may be safely used in a greater number of patients (including elderly patients with structural heart diseases).