Dronedarone

Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular mortality, stroke, and hospitalization in the United States. Amiodarone is generally considered as the agent with the best efficacy for maintaining normal sinus rhythm. Despite its efficacy, amiodarone use is often limited by its extensive side effect profile. Dronedarone is a noniodinated benzofuran derivative of amiodarone that has been recently approved by the Food and Drug Administration to reduce cardiovascular hospitalization in patients with AF or atrial flutter. Structural modification of dronedarone was introduced to shorten the half-life, decrease lipophilicity, and minimize noncardiovascular toxicity as compared to amiodarone. This article reviews the pharmacology, adverse effects, and clinical evidence available to date of the use of dronedarone in the management of AF.