Effect of dronedarone versus placebo on atrial fibrillation progression: a post-hoc analysis from ATHENA trial

Abstract Background Atrial fibrillation (AF) may progress over time, leading to greater AF burden. Data suggest that patients receiving rhythm control drugs are less likely more severe forms of vs those a rate strategy only. ATHENA (NCT00174785) demonstrated dronedarone significantly decreased cardiovascular (CV) hospitalization and death [1], but it is unclear whether affects progression atrial flutter (AFL). Purpose This post hoc analysis assessed (1) the effect on estimated AF/AFL burden, (2) presumed permanent or regression sinus (SR). Methods burden was using modified Rosendaal method [2] based status all ECG assessments at each visit. Cumulative incidence (defined as ≥6 months until end study) preserved SR (≥6 were calculated complement Kaplan-Meier estimates. Log-rank test used assess statistical significance. Results Demographic characteristics in 2231 placebo 2208 well balanced between groups. Overall, 304 (13.8%) dronedarone-treated progressed compared with 455 (20.4%) treated placebo. Patients progressing tended have larger left diameters lower ventricular ejection fractions irrespective treatment group. The cumulative time (log-rank p<0.0001; Figure 1). Estimated (Figure 2). 1149 (52.0%) had 1021 (45.8%) placebo-treated patients, higher arm p<0.0001). Treatment-emergent adverse events consistent findings main analysis. Conclusions Dronedarone use associated fewer AF/AFL, regressing SR, suggesting protective benefit against disease progression. Funding Acknowledgement Type funding sources: Private company. Main source(s): Sanofi