Dronedarone for prevention of atrial fibrillation: a dose-ranging study

Touboul, P; Brugada, Josép; Capucci, Alessandro; Crijns, N; Edvardsson, H

doi:10.1016/j.accreview.2003.10.017

Cited by 82 publications

(134 citation statements)

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“…14 Dronedarone was developed to overcome the negative attributes of amiodarone and proved to be effective in the Dronedarone Atrial Fibrillation Study After Electrical Cardioversion (DAFNE) trial. 15 Subsequently, 2 multicenter, double-blind, randomized trials, the American-Australian Trial With Dronedarone in Atrial Fibrillation or Flutter Patients for the Maintenance of Sinus Rhythm (ADO-NIS) and the European Trial in Atrial Fibrillation or Flutter Patients Receiving Dronedarone for the Maintenance of Sinus Rhythm (EURIDIS), assessed the efficacy of dronedarone, 400 mg twice daily, in patients with recurrent AF after cardioversion. 16 In both trials, treatment with dronedarone significantly delayed recurrence of AF compared with placebo with no major side effects.…”

Section: Antiarrhythmic Drugs For Treatment Of Atrial Fibrillationmentioning

confidence: 99%

Rhythm Control for Management of Patients With Atrial Fibrillation: Balancing the Use of Antiarrhythmic Drugs and Catheter Ablation

Viles-González

Fuster

Halperin

et al. 2011

Clinical Cardiology

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Antiarrhythmic drug (AAD) therapy may be beneficial for patients with symptoms attributable to atrial fibrillation despite adequate rate control. The limited long-term efficacy of AAD and the relatively large proportion of patients discontinuing therapy because of side effects led to the development of nonpharmacological therapies to achieve rhythm control. Pressing questions remain about the effect of ablation therapy on long-term patient outcomes. Based on recent clinical trials and meta-analyses, ablation appears more effective and possibly safer than AAD for long-term maintenance of sinus rhythm in selected patients, but the evidence is insufficient to recommend ablation in preference to drug therapy as the first AAD therapy for the majority of patients in whom a rhythm control strategy is justified. Herein, we review the most current evidence supporting the use of AAD and catheter ablation in atrial fibrillation.

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Section: Antiarrhythmic Drugs For Treatment Of Atrial Fibrillationmentioning

confidence: 99%

Rhythm Control for Management of Patients With Atrial Fibrillation: Balancing the Use of Antiarrhythmic Drugs and Catheter Ablation

Viles-González

Fuster

Halperin

et al. 2011

Clinical Cardiology

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“…Abnormalities in deiodinase activity are commonly observed in patients treated with amiodarone. There is an initial decrease in circulating T 3 and an increase in rT 3 due to inhibition of D1 and to a lesser extent D2 by amiodarone. 9 As a consequence, T 4 and TSH secretion increase raising the free T 4 levels by 20 -40% in the first few months of treatment followed by a fall to normal levels, and a fall in T 3 levels, which may persist over the course of treatment.…”

Section: Inherent Effects Of Amiodarone On the Thyroidmentioning

confidence: 99%

“…Iodine is actively transported via sodium/iodide symporters (NIS) into follicular thyrocytes where it is organified onto tyrosyl residues in thyroglobulin first to produce monoiodotyrosine (MIT), and then diiodotyrosine (DIT). Thyroid peroxidase (TPO) then links two DITs to form the two-ringed structure T 4 , and MIT and DIT to form small amounts of T 3 and reverse T 3 (rT 3 ). The production of thyroid hormones is stimulated by hypothalamic TRH and pituitary thyroidstimulating hormone (TSH).…”

Section: Physiology Of Thyroid Hormonesmentioning

confidence: 99%

“…The pathogenesis of amiodarone-induced thyroid dysfunction is complex but the inherent effects of amiodarone itself as well as its high iodine content appear to play a central role. Due to undesirable adverse effects of amiodarone, analogues such as dronedarone 3,4 and celivarone 5,6 have been developed by the removal of iodine atoms and structural alteration. Dronedarone is the most clinically established analogue being assessed as an anti-arrhythmic agent.…”

Section: Introductionmentioning

confidence: 99%

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Benzofuran derivatives and the thyroid

Han

Williams

Vanderpump

2008

Clinical Endocrinology

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SummaryAmiodarone and dronedarone are two clinically important benzofuran derivatives. Amiodarone has been used widely for treating resistant tachyarrhythmias in the past three decades. However amiodarone and its main metabolically active metabolite desethylamiodarone can adversely affect many organs, including the thyroid gland. Amiodarone-induced thyroid disorders are common and often present as a management challenge for endocrinologists. The pathogenesis of amiodarone-induced thyroid dysfunction is complex but the inherent effects of the drug itself as well as its high iodine content appear to play a central role. The non-iodinated dronedarone also exhibits anti-arrhythmic properties but appears to be less toxic to the thyroid. This review describes the biochemistry of benzofuran derivatives, including their pharmacology and the physiology necessary for understanding the cellular mechanisms involved in their actions. The known effects of these compounds on thyroid action are described. Recommendations for management of amiodarone-induced hypothyroidism and thyrotoxicosis are suggested. Dronedarone appears to be an alternative but less-effective anti-arrhythmic agent and it does not have adverse effects on thyroid function. It may have a future role as an alternative agent in patients being considered for amiodarone therapy especially those at high risk of developing thyroid dysfunction but not in severe heart failure.

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“…Dronedarone is a noniodinated amiodarone derivative that produces similar cardiac effects but with less toxicity 132 because the iodine moiety of amiodarone is thought to be responsible for many of its adverse effects. Dronedarone has been shown to be more effective than placebo in preventing the recurrence of AF, 133 although the Antiarrhythmic Trial With Dronedarone in Moderate-to-Severe Congestive Heart Failure Evaluating Morbidity Decrease (ANDROMEDA) was stopped prematurely because of increased mortality rates among patients with heart failure who were assigned to the dronedarone arm. Tedisamil, another new AAD that was initially developed to treat ischemia by potassium channel blockade, is a class III antiarrhythmic agent that has been shown to be superior to placebo in converting AF to sinus rhythm.…”

Section: Pharmacological Therapy For Maintaining Sinus Rhythmmentioning

confidence: 99%