WEDNESDAY, Sept. 5 (HealthDay News) -- Dronedarone, a new antiarrhythmic agent, and dual-chamber minimal ventricular pacing are effective treatments for patients with atrial fibrillation, according to two studies published in the Sept. 6 issue of the New England Journal of Medicine.
Bramah N. Singh, M.D., of the Veterans Affairs Greater Los Angeles Healthcare System, and colleagues randomly assigned 828 patients to receive either 400 milligrams of dronedarone or placebo and followed them for one year. During recurrences of arrhythmia, they found that the dronedarone group had significantly better sinus rhythm maintenance and a lower ventricular rate than the placebo group.
Michael O. Sweeney, M.D., of Brigham and Women's Hospital in Boston, and colleagues randomly assigned 1,065 patients to receive either conventional dual-chamber pacing or dual-chamber minimal ventricular pacing. They found that dual-chamber minimal ventricular pacing was more effective at preventing ventricular desynchronization and that it also moderately reduced the risk of persistent atrial fibrillation.
"Pulmonary-vein ablation is successful in selected patients but is unlikely to satisfy the needs of the millions of patients with atrial fibrillation," states the author of an accompanying editorial. "My bet is on the multimechanism approach [which targets several different electrophysiological mechanisms simultaneously]. Singh and his colleagues may have signaled that the best is yet to come."
Abstract - Singh
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Abstract - Sweeney
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Editorial
