Related Experiment Video

Updated: May 22, 2025

Transesophageal Atrial Burst Pacing for Atrial Fibrillation Induction in Rats
05:12

Transesophageal Atrial Burst Pacing for Atrial Fibrillation Induction in Rats

Published on: February 14, 2022

3.0K

Dronedarone provides effective early rhythm control: post-hoc analysis of the ATHENA trial using EAST-AFNET 4

Paulus Kirchhof1,2,3, A John Camm4, Harry J G M Crijns5

  • 1Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|April 28, 2025
PubMed

Insights

Dronedarone significantly reduced cardiovascular events in early atrial fibrillation (AF) patients. Early rhythm control with dronedarone is supported for selected early AF patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • The ATHENA trial (NCT00174785) investigated dronedarone for atrial fibrillation (AF).
  • The EAST-AFNET 4 trial (NCT01288352) established criteria for early rhythm control in AF.

Purpose of the Study:

  • To assess if dronedarone (400 mg twice daily) improves cardiovascular outcomes in early atrial fibrillation/atrial flutter (AF) patients with comorbidities.
  • To evaluate dronedarone's efficacy and safety based on EAST-AFNET 4 inclusion criteria and outcomes.

Main Methods:

  • Post-hoc analysis of the ATHENA trial involving 1810 patients with early AF.
  • Co-primary outcomes included a composite of cardiovascular death, stroke, or hospitalizations for heart failure/acute coronary syndrome, and nights in hospital per year.
  • Secondary outcome was sinus rhythm at 12 months; primary safety outcome was a composite of death, stroke, or serious adverse events related to rhythm control therapy.

Main Results:

  • Dronedarone significantly reduced the composite of cardiovascular death, stroke, or hospitalizations (HR 0.71; P=0.014).
  • No difference in hospital nights between groups.
  • More patients on dronedarone achieved sinus rhythm (69.2%) versus placebo (60.8%).
  • No significant difference in primary safety events between dronedarone and placebo groups.

Conclusions:

  • Dronedarone demonstrated efficacy in reducing cardiovascular events in early AF patients.
  • The findings support early rhythm control therapy with dronedarone in selected early AF patients.
Abstract

Keywords:
Atrial fibrillationAtrial flutterDronedaroneEarly rhythm control

More Related Videos

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

345
Analyzing Long-Term Electrocardiography Recordings to Detect Arrhythmias in Mice06:07

Analyzing Long-Term Electrocardiography Recordings to Detect Arrhythmias in Mice

Published on: May 23, 2021

3.5K

Related Concept Videos

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
879
Disturbances in Heart Rhythm01:28

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
812
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
695
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
746
Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
749