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Currently available antiarrhythmic drugs have suboptimal efficacy for patients with atrial fibrillation (AF), and many also have potentially serious side effects. Dronedarone is a new antiarrhythmic drug (not yet USFDA approved) that is similar to amiodarone but has been engineered to reduce accumulation in tissues, which might ameliorate side effects. In an industry-sponsored trial, 4628 patients with AF and high-risk features were randomized to dronedarone or placebo.
After a mean follow-up of 21 months, the incidence of the primary combined outcome of death or first hospitalization due to adverse cardiovascular events was significantly lower in the dronedarone group than in the placebo group (31.9% vs. 39.4%). The rate of cardiovascular-r…