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(Circulation. 2009;120:636-644.)
© 2009 American Heart Association, Inc.

New Drugs and Technologies

Dronedarone

Chinmay Patel, MD; Gan-Xin Yan, PhD; Peter R. Kowey, MD

From the Main Line Health Heart Center and Lankenau Hospital (C.P., G.X.Y., P.R.K.), Wynnewood; Jefferson Medical College, Thomas Jefferson University (G.X.Y., P.R.K.), Philadelphia; and Lankenau Institute for Medical Research (G.X.Y.), Wynnewood, Pa.

Correspondence to Dr Peter R. Kowey, Main Line Health Heart Center, 100 Lancaster Ave, MOBE 558, Wynnewood, PA 19096. E-mail koweyp{at}mlhs.org

Amiodarone is the most effective antiarrhythmic drug for maintaining sinus rhythm for patients with atrial fibrillation. Extra-cardiac side effects have been a limiting factor, especially during chronic use, and may offset its benefits. Dronedarone is a noniodinated benzofuran derivative of amiodarone that has been developed for the treatment of atrial fibrillation and atrial flutter. Similar to amiodarone, dronedarone is a potent blocker of multiple ion currents, including the rapidly activating delayed-rectifier potassium current, the slowly activating delayed-rectifier potassium current, the inward rectifier potassium current, the acetylcholine activated potassium current, peak sodium current, and L-type calcium current, and exhibits antiadrenergic effects. It has been studied for maintenance of sinus rhythm and control of ventricular response during episodes of atrial fibrillation. Dronedarone reduces mortality and morbidity in patients with high-risk atrial fibrillation, but may be unsafe in those with severe heart failure. This article will review evidence of safety and effectiveness of dronedarone in patients with atrial fibrillation.

Key Words: amiodarone • arrhythmia • atrial fibrillations • dronedarone