Amiodarone or Dronedarone for Atrial Fibrillation?

Dronedarone (Multaq) is a new FDA-approved antiarrhythmic agent that is similar to amiodarone but has been engineered to minimize side effects. In the placebo-controlled ATHENA trial, dronedarone lowered the incidence of death or hospitalization due to adverse cardiovascular events in patients with paroxysmal or persistent atrial fibrillation (AF; JW Gen Med Apr 7 2009). However, limited head-to-head data on safety and efficacy are available. In this meta-analysis, focused on prevention of recurrent AF, investigators combined data from four placebo-controlled trials of dronedarone, four trials of amiodarone versus placebo, and one as-yet-unpublished trial in which the two agents were compared directly.

AF was significantly less common in pat…