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Chahal CA, Ali O, Hunter RJ, et al. Impact of controlling atrial fibrillation on outcomes relevant to the patient: focus on dronedarone. Patient Relat Outcome Meas. 2012;3:95-103doi: 10.2147/PROM.S16678.
Chahal, C. A., Ali, O., Hunter, R. J., & Schilling, R. J. (2012). Impact of controlling atrial fibrillation on outcomes relevant to the patient: focus on dronedarone. Patient related outcome measures, 395-103. https://doi.org/10.2147/PROM.S16678
Chahal, C Anwar A, et al. "Impact of controlling atrial fibrillation on outcomes relevant to the patient: focus on dronedarone." Patient related outcome measures vol. 3 (2012): 95-103. doi: https://doi.org/10.2147/PROM.S16678
Chahal CA, Ali O, Hunter RJ, Schilling RJ. Impact of controlling atrial fibrillation on outcomes relevant to the patient: focus on dronedarone. Patient Relat Outcome Meas. 2012;3:95-103. doi: 10.2147/PROM.S16678. Epub 2012 Dec 19. PMID: 23378791; PMCID: PMC3557702.
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Patient Relat Outcome Meas. 2012;3:95-103. doi: 10.2147/PROM.S16678. Epub 2012 Dec 19.

Impact of controlling atrial fibrillation on outcomes relevant to the patient: focus on dronedarone.

Patient related outcome measures

C Anwar A Chahal, Omer Ali, Ross J Hunter, Richard J Schilling

Affiliations

  1. Department of Cardiology Research, St Bartholomew's Hospital, London, United Kingdom.

PMID: 23378791 PMCID: PMC3557702 DOI: 10.2147/PROM.S16678

Abstract

Atrial fibrillation (AF) is a substantial cause of mortality and morbidity in the Western world. It is a massive burden on health care systems, and its prevalence is expected to double over the next 20 years. Trials evaluating antiarrhythmic drugs or catheter ablation have focused on recurrence of arrhythmia, perhaps neglecting outcomes relevant to patients, such as symptoms, need for antiarrhythmic drugs, need for hospitalization, and rates of stroke and death. An association has been demonstrated between sinus rhythm and survival in several studies, and there is evidence emerging that successful catheter ablation may reduce rates of stroke and death. Similarly, dronedarone has been shown to reduce hospitalizations and death in patients with paroxysmal AF or persistent AF of recent onset, although it may cause adverse events in permanent AF. New antiarrhythmic drugs are a welcome addition to the armamentarium, since there are limitations to current antiarrhythmic drugs. In particular, sotalol, flecainide, and propafenone cannot be used safely in those with structural heart disease, and amiodarone has important adverse reactions that limit long-term use. Indeed, the use of conventional antiarrhythmic drugs may negate any survival benefit derived from maintaining sinus rhythm. Although dronedarone appears promising with respect to hard endpoints such as stroke and death in certain patients, it may not be safe for those with heart failure or those with permanent AF. Furthermore, the trials suggesting that dronedarone may impact on these endpoints were compared with placebo rather than with an active comparator group. Further "head-to-head" comparisons between dronedarone and other antiarrhythmic drugs are needed to determine whether this property is unique to dronedarone alone.

Keywords: ablation; antiarrhythmics; atrial fibrillation; dronedarone; rhythm; stroke

References

  1. Am Heart J. 2008 Sep;156(3):527.e1-9 - PubMed
  2. JAMA. 2010 Jan 27;303(4):333-40 - PubMed
  3. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005049 - PubMed
  4. J Am Coll Cardiol. 2004 Jan 21;43(2):241-7 - PubMed
  5. J Am Coll Cardiol. 2003 Jul 16;42(2):185-97 - PubMed
  6. J Am Coll Cardiol. 2011 Jan 18;57(3):313-21 - PubMed
  7. J Am Coll Cardiol. 2008 Feb 26;51(8):843-9 - PubMed
  8. JAMA. 2005 Jun 1;293(21):2634-40 - PubMed
  9. Heart. 2010 Sep;96(17):1372-8 - PubMed
  10. Eur J Pharmacol. 1995 Jun 6;279(1):25-32 - PubMed
  11. JAMA. 2001 May 9;285(18):2370-5 - PubMed
  12. J Am Coll Cardiol. 2006 Dec 5;48(11):2340-7 - PubMed
  13. J Am Coll Cardiol. 2010 Feb 23;55(8):735-43 - PubMed
  14. N Engl J Med. 2002 Dec 5;347(23):1825-33 - PubMed
  15. J Am Coll Cardiol. 2009 Sep 15;54(12):1089-95 - PubMed
  16. Circ Arrhythm Electrophysiol. 2011 Oct;4(5):637-43 - PubMed
  17. J Am Coll Cardiol. 2011 Jan 11;57(2):223-42 - PubMed
  18. J Cardiovasc Electrophysiol. 2010 Jun 1;21(6):597-605 - PubMed
  19. J Cardiovasc Electrophysiol. 2011 Aug;22(8):839-45 - PubMed
  20. N Engl J Med. 2008 Jun 19;358(25):2678-87 - PubMed
  21. N Engl J Med. 2006 Mar 2;354(9):934-41 - PubMed
  22. J Cardiovasc Pharmacol. 2003 Feb;41(2):191-202 - PubMed
  23. Circulation. 2008 Dec 9;118(24):2498-505 - PubMed
  24. J Cardiovasc Electrophysiol. 2007 Jan;18(1):9-14 - PubMed
  25. Br J Clin Pharmacol. 2007 Dec;64(6):785-91 - PubMed
  26. Circulation. 2004 Mar 30;109(12):1509-13 - PubMed
  27. J Cardiovasc Electrophysiol. 2006 Sep;17 Suppl 2:S17-20 - PubMed
  28. N Engl J Med. 2007 Sep 6;357(10):987-99 - PubMed
  29. Europace. 2007 Jun;9(6):335-79 - PubMed
  30. Eur Heart J. 2006 Jan;27(2):216-21 - PubMed
  31. Eur Heart J. 2003 Aug;24(16):1481-7 - PubMed
  32. Circ Cardiovasc Qual Outcomes. 2011 May;4(3):313-20 - PubMed
  33. N Engl J Med. 2009 Feb 12;360(7):668-78 - PubMed
  34. N Engl J Med. 2011 Dec 15;365(24):2268-76 - PubMed
  35. Europace. 2009 Apr;11(4):402-4 - PubMed
  36. N Engl J Med. 2004 Dec 2;351(23):2373-83 - PubMed
  37. Indian Pacing Electrophysiol J. 2009 Sep 01;9(5):260-7 - PubMed
  38. Heart Rhythm. 2008 Nov;5(11):1501-7 - PubMed
  39. N Engl J Med. 2008 Oct 23;359(17):1778-85 - PubMed
  40. Pharmacotherapy. 2010 Sep;30(9):904-15 - PubMed
  41. Heart. 2012 Jan;98(1):48-53 - PubMed
  42. Stroke. 1991 Aug;22(8):983-8 - PubMed
  43. Heart. 2006 Feb;92(2):155-61 - PubMed
  44. Pacing Clin Electrophysiol. 2006 Sep;29(9):962-70 - PubMed
  45. Am J Cardiol. 2009 Dec 1;104(11):1534-9 - PubMed
  46. Eur Heart J. 2012 Nov;33(21):2719-47 - PubMed
  47. Cardiovasc Drug Rev. 2005 Fall;23(3):217-30 - PubMed
  48. J Cardiovasc Electrophysiol. 2012 May;23(5):462-72 - PubMed

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