1887
Volume 2015, Issue 1
  • ISSN: 2305-7823
  • EISSN:

Abstract

In the Permanent Atrial Fibrillation Outcome Study Using Dronedarone on Top of Standard Therapy (PALLAS) study, dronedarone use was associated with an excess risk of stroke, cardiovascular death and hospitalizations. However, an increased level in the serum digoxin level was observed in the dronedarone arm, as it is a potent inhibitor of the P-glycoprotein transport system. The PALLAS subanalysis suggests that digoxin-dronedarone interaction was responsible for the higher arrhythmic death rate observed in the trial. These data are consistent with several other studies that demonstrate the potential hazard of the use of digoxin in heart failure and/or atrial fibrillation. One must consider other safer alternatives before prescribing digoxin in atrial fibrillation patients.

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2015-03-01
2024-04-19
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References

  1. Zimetbaum P. Antiarrhythmic Drug Therapy for Atrial Fibrillation. Circulation 2012; 125:2:381389. doi:10.1161/CIRCULATIONAHA.111.019927 .
    [Google Scholar]
  2. Hohnloser S, Crijns H, van Eickels M, Gaudin C, Page R, Torp-Pedersen C, Connolly SJ. Effect of dronedarone on cardiovascular events in atrial fibrillation. Rev Port Cardiol. 2009; 28::345347.
    [Google Scholar]
  3. Connolly SJ, Camm AJ, Halperin JL, Joyner C, Alings M, Amerena J, Atar D, Avezum Á, Blomström P, Borggrefe M, Budaj A, Chen S-A, Ching CK, Commerford P, Dans A, Davy J-M, Delacrétaz E, Di Pasquale G, Diaz R, Dorian P, Flaker G, Golitsyn S, Gonzalez-Hermosillo A, Granger CB, Heidbüchel H, Kautzner J, Kim JS, Lanas F, Lewis BS, Merino JL, Morillo C, Murin J, Narasimhan C, Paolasso E, Parkhomenko A, Peters NS, Sim K-H, Stiles MK, Tanomsup S, Toivonen L, Tomcsányi J, Torp-Pedersen C, Tse H-F, Vardas P, Vinereanu D, Xavier D, Zhu J, Zhu J-R, Baret-Cormel L, Weinling E, Staiger C, Yusuf S, Chrolavicius S, Afzal R, Hohnloser SH. Dronedarone in High-Risk Permanent Atrial Fibrillation. N Eng J Med. 2011; 365:24:22682276. doi:10.1056/NEJMoa1109867..
    [Google Scholar]
  4. Hohnloser SH, Halperin JL, Camm AJ, Gao P, Radzik D, Connolly SJ. Interaction Between Digoxin and Dronedarone in the PALLAS Trial. 2014.
    [Google Scholar]
  5. Singh BN, Connolly SJ, Crijns HJGM, Roy D, Kowey PR, Capucci A, Radzik D, Aliot EM, Hohnloser SH. Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter. N Engl J Med. 2007; 357::987999.
    [Google Scholar]
  6. Køber L, Torp-Pedersen C, McMurray JJV, Gøtzsche O, Lévy S, Crijns H, Amlie J, Carlsen J. Increased mortality after dronedarone therapy for severe heart failure. N Engl J Med. 2008; 358::26782687.
    [Google Scholar]
  7. Piccini JP, Hasselblad V, Peterson ED, Washam JB, Califf RM, Kong DF. Comparative Efficacy of Dronedarone and Amiodarone for the Maintenance of Sinus Rhythm in Patients With Atrial Fibrillation. J Am Coll Cardiol. 2009; 54::10891095.
    [Google Scholar]
  8. Withering W, An account of the Foxglove and some of its medical uses: with practical remarks on dropsy, and other diseases. Birmingham: G.G.J and J. Robinson, Paternoster-Row, London 1785.
  9. Packer M, Gheorghiade M, Young JB, Costantini PJ, Adams KF, Cody RJ, Smith K, Van Voorhees L, Gourley LA, Jolly MK. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors. N Eng J Med. 1993; 329:1:17. doi:10.1056/NEJM199307013290101..
    [Google Scholar]
  10. Uretsky BF, Young JB, Shahidi FE, Yellen LG, Harrison MC, Jolly MK. Randomized study assessing the effect of digoxin withdrawal in patients with mild to moderate chronic congestive heart failure: results of the PROVED trial. PROVED Investigative Group. J Am Coll Cardiol. 1993; 22:4:955962.
    [Google Scholar]
  11. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997; 336:8:525533. doi:10.1056/NEJM199702203360801..
    [Google Scholar]
  12. Freeman JV, Yang J, Sung SH, Hlatky MA, Go AS. Effectiveness and safety of digoxin among contemporary adults with incident systolic heart failure. Circ Cardiovasc Qual Outcomes. 2013; 6::525533.
    [Google Scholar]
  13. Whitbeck MG, Charnigo RJ, Khairy P, Ziada K, Bailey AL, Zegarra MM, Shah J, Morales G, Macaulay T, Sorrell VL, Campbell CL, Gurley J, Anaya P, Nasr H, Bai R, Di Biase L, Booth DC, Jondeau G, Natale A, Roy D, Smyth S, Moliterno DJ, Elayi CS. Increased mortality among patients taking digoxin–analysis from the AFFIRM study. Eur Heart J [Internet]. 2013; 34::14811488. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23186806 .
    [Google Scholar]
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