Benefit-Risk Assessment of Current Antiarrhythmic Drug Therapy of Atrial Fibrillation
Article first published online: 13 JAN 2012
© 2012 Wiley Periodicals, Inc.
Supplement: Atrial Fibrillation–Predicting Its Course
Volume 35, Issue S1, pages S28–S32, January 2012
How to Cite
Hohnloser, S. H. (2012), Benefit-Risk Assessment of Current Antiarrhythmic Drug Therapy of Atrial Fibrillation. Clin Cardiol, 35: S28–S32. doi: 10.1002/clc.20959
- Issue published online: 13 JAN 2012
- Article first published online: 13 JAN 2012
- Manuscript Accepted: 8 AUG 2011
- Manuscript Received: 10 JUL 2011
Over the last decade, several rhythm-versus rate-control trails in patients with atrial fibrillation (AF) have failed to demonstrate benefit of the rhythm control strategy with respect to mortality and morbidity. This had let to the guideline recommendation that antiarrhythmic drug therapy should be considered predominantly for sympt0matic improvement of patients. Recent trails and meta-analyses have demonstrated that amiodarone is the most antiarrhythmic drug currently available. However, its use has been associated with many adverse effects. Currently, dronedarone is the only available antiarrhythmic drug which has shown a reduction in cardiovascular hospitalizations in medium-risk AF patients. However, the drug was associated with increased mortality in patients with recently decompensated heart failure. Hence, antiarrhythmic drug therapy has to be evaluated in patients with AF on an individual patients basis.
Dr. Hohnloser received an honorarium through an educational grant from Sanofi Aventis for time and expertise spent writing this article. Dr. Hohnloser reports receiving consulting fees from Bayer, BMS; Cardiome, Pfizer, MSD, and Sanofi Aventis; research grants from Sanofi Aventis and St. Jude Medical, and lecture fees from BMS, Cardiome, Medtronic, Sanofi Aventis, and St. Jude Medical.