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Review
. 2010 Mar 27:2:17-23.
doi: 10.2147/oaem.s8988. eCollection 2010.

Dronedarone in the management of atrial fibrillation

Ts Mohamed Saleem  1 , K Bharani  1 , C Madhusudhana Chetty  1 , K Gauthaman  2
Affiliations
Review

Dronedarone in the management of atrial fibrillation

Ts Mohamed Saleem et al. Open Access Emerg Med. .

Abstract

Atrial fibrillation is the most common type of tachyarrhythmia caused by multiple re-entrant wave forms within the atria and bombarding the atrioventricular node several times making it beat in a rapid, disorganized fashion termed "fibrillation". In atrial fibrillation, atria beat more than 300 times per minute. The arrhythmatous condition needs to be controlled, as humans cannot withstand this rapid and chaotic beating of the heart. New investigational drugs like Dronedarone(®) are being used. Dronedarone is the most recent antiarrhythmic drugs. It was approved by US-FDA on July 2nd 2009 and is available in the USA as Multaq tablets (400 mg). Dronedarone falls under the category of multiple ion channel blocker. It mainly targets the repolarization currents, making them less active and hence prolonging the action potential duration (APD). Dronedarone also exhibits antiadrenergic activity, thus reducing the pace of the pacemaker. Dronedarone has been proven to be a safer and efficacious AAD, evidenced by both animal and human studies. These studies showed that there was prolongation of the APD and absence of QT interval prolongation with long term administration of the drug. Also there was reduced thyroid hormone receptor expression. Dronedarone is significantly safer and effective in maintaining the sinus rhythm and reducing the ventricular proarrhythmias, justifying it for the long term treatment of atrial fibrillation compared to other antiarrhythmic drugs.

Keywords: antiarrhythmic drugs; atrial fibrillation; dronedarone; ion channel blocker; multaq.

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Figures

Figure 1
Figure 1
Structure of dronedarone.
Figure 2
Figure 2
Structure of amiodarone.
Figure 3
Figure 3
The five phases of the cardic myocyte action potential.
Figure 4
Figure 4
Controlled action potential versus remodeled action potential in AF. Abbreviations: AF, atrial fibrillation; SR, sinus rhythm.
See this image and copyright information in PMC

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