Dronedarone Hydrochloride

In spontaneously hypertensive rats (10‑month‑old males), dronedarone (100 mg/kg/day for 14 days) reduced septal wall thickness, posterior wall thickness, ventricular mass, myocardial glucose uptake (by PET/CT), myocyte size, and collagen content to levels similar to normotensive Wistar‑Kyoto controls. The untreated hypertensive group showed classic left ventricular hypertrophy. Dronedarone, an antiarrhythmic agent, reversed established hypertensive LVH in this model, suggesting a potential additional cardioprotective effect.

Fig. 1 Examples of histological sections of the left ventricle. (Quintana-Villamandos B, et al., 2017)

In a post‑hoc analysis of the ATHENA trial (1,810 patients with early atrial fibrillation and cardiovascular comorbidities), dronedarone 400 mg twice daily reduced the composite of cardiovascular death, stroke, or hospitalization for worsening heart failure or acute coronary syndrome compared with placebo (HR 0.71, 95% CI 0.54‑0.94, P=0.014). More patients on dronedarone achieved sinus rhythm at 12 months (69.2% vs. 60.8%). Primary safety events (death, stroke, or rhythm‑control serious adverse events) did not differ. These data support dronedarone for early rhythm control in selected patients.

Fig. 2 Primary composite outcome (death from cardiovascular causes, stroke, or hospitalisation due to worsening of HF or ACS) for dronedarone vs. placebo in patients with early AF. (Kirchhof P, et al., 2025)