Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.
Cardiol J. 2013;20(5):486-90. doi: 10.5603/CJ.2013.0133.
Dronedarone is a new antiarrhythmic drug used in the treatment of atrial fibrillation (AF). We investigate its efficacy and tolerability in clinical practice.
We identified 208 patients treated with dronedarone for AF at the Northwestern outpatient practice. Charts were reviewed for clinical efficacy and reasons for discontinuation of the drug.
The average age was 65.2 ± 10.8 years, 37% females. Paroxysmal, persistent andpermanent AF were noted in 46.2%, 51.9%, and 1.9%, respectively. Average ejection fraction was 56.3 ± 9.1%, 12.8% had a history of congestive heart failure, and 10.3% had valvularheart disease. Dronedarone was discontinued in 25 patients after curative catheter or surgical ablation procedure. Of the remaining 183 patients, dronedarone was discontinued in 48.6% after a mean duration of 6.2 ± 6.3 months because of in efficacy (26.2%), side effects (6%), and other reasons (16.4%). For those remaining on dronedarone (n = 94), after a mean of 11.6 ± 6.6 months, clinical efficacy (resolution of or patient-reported improvement in symptoms) was noted in 45.4% patients. On dronedarone therapy, 57.4% had no AF on follow-up (overallefficacy of 29.5%). To evaluate efficacy, ECG only or long-term monitoring were performed in 62.7% and 37.3%, respectively, and found no AF in 69.2 and 48.4%, respectively. There were 3 deaths and 2 transient ischemic attacks (TIA) off dronedarone vs. 1 death, 1 TIA and 2 strokes on dronedarone.
Dronedarone has a significant discontinuation rate due to both inefficacy and side effects in clinical practice. Nevertheless, it has moderate clinical efficacy and tolerability in an outpatient population of patients with AF.
多非利特是一种新型抗心律失常药物，用于治疗心房颤动（AF）。我们在临床实践中研究其疗效和耐受性。
我们在西北门诊实践中确定了 208 例使用多非利特治疗 AF 的患者。对图表进行了回顾，以了解药物的临床疗效和停药原因。
平均年龄为 65.2±10.8 岁，女性占 37%。阵发性、持续性和永久性 AF 分别为 46.2%、51.9%和 1.9%。平均射血分数为 56.3±9.1%，12.8%有充血性心力衰竭病史，10.3%有心脏瓣膜病。25 例患者在接受根治性导管或手术消融术后停用多非利特。在其余 183 例患者中，48.6%（平均持续时间为 6.2±6.3 个月）因疗效不佳（26.2%）、副作用（6%）和其他原因（16.4%）停用多非利特。对于其余服用多非利特的患者（n=94），在平均 11.6±6.6 个月后，45.4%的患者观察到临床疗效（症状缓解或患者报告的改善）。在多非利特治疗期间，57.4%的患者在随访期间无 AF（总体疗效为 29.5%）。为了评估疗效，62.7%和 37.3%分别仅通过心电图或长期监测进行评估，分别在 69.2%和 48.4%的患者中发现无 AF。停用多非利特后有 3 例死亡和 2 例短暂性脑缺血发作（TIA），而在服用多非利特期间有 1 例死亡、1 例 TIA 和 2 例中风。
多非利特在临床实践中由于疗效不佳和副作用而导致停药率较高。然而，它在 AF 门诊患者中具有中等的临床疗效和耐受性。
