A Head-to-Head Comparison of Two Drugs for Atrial Fibrillation

Amiodarone is the most effective agent for treating persistent atrial fibrillation (AF). However, it is not FDA approved for this indication, and its adverse effects on thyroid, liver, and pulmonary function limit its use, especially in the long term. Dronedarone, which received FDA approval for AF treatment in 2009, is chemically similar to amiodarone but differs in iodine content and tissue absorption, putatively reducing its toxicity — a hypothesis supported by the results of the placebo-controlled ATHENA trial (JW Cardiol Feb 11 2009). Now, investigators have compared the effectiveness and safety of dronedarone and amiodarone in an international, manufacturer-sponsored, randomized controlled trial involving 504 patients with AF requirin…