Dronedarone: evidence supporting its therapeutic use in the treatment of atrial fibrillation

INTRODUCTION: Dronedarone, a benzofuran derivative with a structure similar to amiodarone, has been developed as a potential therapy for patients with atrial fibrillation. AIM: To review the published evidence regarding the efficacy and safety of dronedarone use in patients with atrial fibrillation. EVIDENCE REVIEW: Available evidence suggests that dronedarone 400 mg orally twice daily can lengthen the time to and decrease the overall recurrence of atrial fibrillation compared with placebo. Dronedarone may reduce risk of mortality and cardiovascular hospitalization. Patients with atrial fibrillation receiving dronedarone had improved ventricular rate control compared with patients receiving placebo. Dronedarone is associated with few serious adverse events except, notably, in patients with decompensated heart failure. PLACE IN THERAPY: Dronedarone may have a role in rate and rhythm control for patients with atrial fibrillation. Dronedarone can reduce unique, but potentially serious, end points in patients with atrial fibrillation. Despite this, the exact role of dronedarone in the management of patients with atrial fibrillation continues to emerge. It remains uncertain if dronedarone should be considered a primary treatment strategy for atrial fibrillation. Dronedarone should not be administered to patients with decompensated heart failure. CONCLUSION: Dronedarone is a unique drug that may serve a key role to treat patients with atrial fibrillation.