{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T01:56:36Z","timestamp":1774230996360,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sanofi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>This post hoc analysis of the ATHENA trial (NCT00174785) assessed the effect of dronedarone on the estimated burden of atrial fibrillation (AF)\/atrial flutter (AFL) progression to presumed permanent AF\/AFL, and regression to sinus rhythm (SR), compared with placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>The burden of AF\/AFL was estimated by a modified Rosendaal method using available electrocardiograms (ECG). Cumulative incidence of permanent AF\/AFL (defined as \u22656 months of AF\/AFL until end of study) or permanent SR (defined as \u22656 months of SR until end of study) were calculated using Kaplan\u2013Meier estimates. A log-rank test was used to assess statistical significance. Hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were estimated using a Cox model, adjusted for treatment group. Of the 4439 patients included in this analysis, 2208 received dronedarone, and 2231 placebo. Baseline and clinical characteristics were well balanced between groups. Overall, 304 (13.8%) dronedarone-treated patients progressed to permanent AF\/AFL compared with 455 (20.4%) treated with placebo (P &amp;lt; 0.0001). Compared with those receiving placebo, patients receiving dronedarone had a lower cumulative incidence of permanent AF\/AFL (log-rank P &amp;lt; 0.001; HR: 0.65; 95% CI: 0.56\u20130.75), a higher cumulative incidence of permanent SR (log-rank P &amp;lt; 0.001; HR: 1.19; 95% CI: 1.09\u20131.29), and a lower estimated AF\/AFL burden over time (P &amp;lt; 0.01 from Day 14 to Month 21).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results suggest that dronedarone could be a useful antiarrhythmic drug for early rhythm control due to less AF\/AFL progression and more regression to SR vs. placebo, potentially reflecting reverse remodeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>NCT00174785<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euad023","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T18:42:05Z","timestamp":1675968125000},"page":"845-854","source":"Crossref","is-referenced-by-count":19,"title":["Effect of dronedarone vs. placebo on atrial fibrillation progression: a<i>post hoc<\/i>analysis from ATHENA trial"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-3903","authenticated-orcid":false,"given":"Carina","family":"Blomstr\u00f6m-Lundqvist","sequence":"first","affiliation":[{"name":"Department of Medical Science, Uppsala University , Uppsala, 751 85 , Sweden"},{"name":"Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro, SE-701 82 , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald V","family":"Naccarelli","sequence":"additional","affiliation":[{"name":"Penn State University College of Medicine, Penn State Hershey Heart and Vascular Institute , 500 University Drive, Hershey, PA 17033 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4402-6814","authenticated-orcid":false,"given":"David S","family":"McKindley","sequence":"additional","affiliation":[{"name":"Sanofi, Bridgewater , 55 Corporate Drive, NJ 08807 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Bigot","sequence":"additional","affiliation":[{"name":"IVIDATA Life Sciences , 79 Rue Baudin, Paris, 92300 Levallois-Perret , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7425-6549","authenticated-orcid":false,"given":"Mattias","family":"Wieloch","sequence":"additional","affiliation":[{"name":"Sanofi , Rue la Boetie 54-56, Paris 75008 , France"},{"name":"Department of Coagulation Disorders, Lund University , Jan Waldenstr\u00f6ms gata 14, Lund 20502 , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5030-3315","authenticated-orcid":false,"given":"Stefan H","family":"Hohnloser","sequence":"additional","affiliation":[{"name":"Division of Clinical Electrophysiology, Department of Cardiology, J.W. Goethe University , Theodor-Stern-Kai 7, Frankfurt D 60590 , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1093\/europace\/euv390","article-title":"\u2018Real-world\u2019 management and outcomes of patients with paroxysmal vs. non-paroxysmal atrial fibrillation in Europe: the EURObservational Research Programme-Atrial Fibrillation (EORP-AF) general pilot registry","volume":"18","author":"Boriani","year":"2016","journal-title":"Europace"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1161\/CIRCULATIONAHA.112.000491","article-title":"Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study","volume":"128","author":"Marijon","year":"2013","journal-title":"Circulation"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart disease and stroke statistics\u20142022 update: a report from the American Heart Association","volume":"145","author":"Tsao","year":"2022","journal-title":"Circulation"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1093\/europace\/euz339","article-title":"Atrial fibrillation progression risk factors and associated cardiovascular outcome in well-phenotyped patients: data from the AF-RISK study","volume":"22","author":"De With","year":"2020","journal-title":"Europace"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jacep.2015.04.010","article-title":"A systematic review on the progression of paroxysmal to persistent atrial fibrillation: shedding new light on the effects of catheter ablation","volume":"1","author":"Proietti","year":"2015","journal-title":"JACC Clin Electrophysiol"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jacc.2009.11.040","article-title":"Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis","volume":"55","author":"de Vos","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1093\/eurheartj\/ehw007","article-title":"The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding: a systematic review and meta-analysis","volume":"37","author":"Ganesan","year":"2016","journal-title":"Eur Heart J"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/S0008-6363(00)00067-5","article-title":"The \u2018second factor\u2019 of tachycardia-induced atrial remodeling","volume":"46","author":"Tieleman","year":"2000","journal-title":"Cardiovasc Res"},{"key":"2023033014155435000_","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1161\/01.CIR.92.7.1954","article-title":"Atrial fibrillation begets atrial fibrillation. 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