Real-World Observations with Dronedarone Compared to Other Anti-Arrhythmic Drugs in Recurrent Atrial Fibrillation
D. Demarie
Maria Vittoria Hospital, Turin, Italy.
F. Orlando
Maria Vittoria Hospital, Turin, Italy.
M. Imazio
Maria Vittoria Hospital, Turin, Italy.
E. Cerrato
Maria Vittoria Hospital, Turin, Italy.
E. Richiardi *
Gradenigo Hospital, Turin, Italy.
R. Belli
Maria Vittoria Hospital, Turin, Italy.Q
*Author to whom correspondence should be addressed.
Abstract
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).
Keywords: Atrial fibrillation, recurrent atrial fibrillation, anti-arrhythmic drugs, ion channel blockers.