{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:50:59Z","timestamp":1788565859496,"version":"build-2803163510"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Sotalol and dronedarone are both used for maintenance of sinus rhythm for patients with atrial fibrillation. However, while sotalol requires initial monitoring for QT prolongation and proarrhythmia, dronedarone does not. These treatments can be used in comparable patients, but their safety and effectiveness have not been compared head to head. Therefore, we retrospectively evaluated the effectiveness and safety using data from a large health care system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Using Veterans Health Administration data, we identified 11\u2009296 antiarrhythmic drug\u2013naive patients with atrial fibrillation prescribed dronedarone or sotalol in 2012 or later. We excluded patients with prior conduction disease, pacemakers or implantable cardioverter-defibrillators, ventricular arrhythmia, cancer, renal failure, liver disease, or heart failure. We used natural language processing to identify and compare baseline left ventricular ejection fraction between treatment arms. We used 1:1 propensity score matching, based on patient demographics, comorbidities, and medications, and Cox regression to compare strategies. To evaluate residual confounding, we performed falsification analysis with nonplausible outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              The matched cohort comprised 6212 patients (3106 dronedarone and 3106 sotalol; mean [\u00b1SD] age, 71\u00b110 years; 2.5% female; mean [\u00b1SD] CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASC, 2\u00b11.3). The mean (\u00b1SD) left ventricular ejection fraction was 55\u00b111 and 58\u00b110 for dronedarone and sotalol users, correspondingly. Dronedarone, compared with sotalol, did not demonstrate a significant association with risk of cardiovascular hospitalization (hazard ratio, 1.03 [95% CI, 0.88\u20131.21]) or all-cause mortality (hazard ratio, 0.89 [95% CI, 0.68\u20131.16]). However, dronedarone was associated with significantly lower risk of ventricular proarrhythmic events (hazard ratio, 0.53 [95% CI, 0.38\u20130.74]) and symptomatic bradycardia (hazard ratio, 0.56 [95% CI, 0.37\u20130.87]). The primary findings were stable across sensitivity analyses. Falsification analyses were not significant.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Dronedarone, compared with sotalol, was associated with a lower risk of ventricular proarrhythmic events and conduction disorders while having no difference in risk of incident cardiovascular hospitalization and mortality. These observational data provide the basis for prospective efficacy and safety trials.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.123.011893","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T09:01:02Z","timestamp":1690189262000},"page":"456-467","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Dronedarone Versus Sotalol in Antiarrhythmic Drug\u2013Naive Veterans With Atrial Fibrillation"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-367X","authenticated-orcid":true,"given":"Krishna","family":"Pundi","sequence":"first","affiliation":[{"name":"Department of Medicine, Stanford University School of Medicine, CA (K.P., M.P.T., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Fan","sequence":"additional","affiliation":[{"name":"Veterans Affairs Palo Alto Health Care System, CA (J.F., N.D., M.P.T., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9945-6491","authenticated-orcid":true,"given":"Shaum","family":"Kabadi","sequence":"additional","affiliation":[{"name":"Sanofi, Bridgewater, NJ (S.K., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5312-4451","authenticated-orcid":true,"given":"Natasha","family":"Din","sequence":"additional","affiliation":[{"name":"Veterans Affairs Palo Alto Health Care System, CA (J.F., N.D., M.P.T., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-3903","authenticated-orcid":true,"given":"Carina","family":"Blomstr\u00f6m-Lundqvist","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University, Sweden (C.B.-L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2536-2871","authenticated-orcid":true,"given":"A. John","family":"Camm","sequence":"additional","affiliation":[{"name":"St. George\u2019s University of London, United Kingdom (A.J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7189-1638","authenticated-orcid":true,"given":"Peter","family":"Kowey","sequence":"additional","affiliation":[{"name":"Lankenau Heart Institute, Wynnewood, PA (P.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-529X","authenticated-orcid":true,"given":"Jagmeet P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA (J.P.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Rashkin","sequence":"additional","affiliation":[{"name":"Sanofi, Bridgewater, NJ (S.K., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7425-6549","authenticated-orcid":true,"given":"Mattias","family":"Wieloch","sequence":"additional","affiliation":[{"name":"Department of Coagulation Disorders, Sk\u00e5ne University Hospital, Lund University, Malm\u00f6, Sweden (M.W.)."},{"name":"Sanofi, Stockholm, Sweden (M.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8025-0904","authenticated-orcid":true,"given":"Mintu P.","family":"Turakhia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University School of Medicine, CA (K.P., M.P.T., A.T.S.)."},{"name":"Veterans Affairs Palo Alto Health Care System, CA (J.F., N.D., M.P.T., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3208-1143","authenticated-orcid":true,"given":"Alexander T.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University School of Medicine, CA (K.P., M.P.T., A.T.S.)."},{"name":"Veterans Affairs Palo Alto Health Care System, CA (J.F., N.D., M.P.T., A.T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001052"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000040"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.060"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2019422"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803778"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707855"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1023\/a:1020579806511"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1077558703256726"},{"key":"e_1_3_3_12_2","volume-title":"VIReC Research User Guide: VHA Decision Support System Clinical National Data Extracts","author":"VA Information Resource Center","year":"2009","unstructured":"VA Information Resource Center. VIReC Research User Guide: VHA Decision Support System Clinical National Data Extracts. 2nd ed. US Dept of Veterans Affairs, Health Services Research and Development Service, VA Information Resource Center; 2009.","edition":"2"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000244657.90074.b7"},{"key":"e_1_3_3_14_2","volume-title":"VIReC Technical Report 2: VANDI Mortality Data Merge Project","author":"Arnold N","year":"2006","unstructured":"Arnold, N, Sohn, MW, Maynard, C. VIReC Technical Report 2: VANDI Mortality Data Merge Project. VA Information Resource Center; 2006."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7954-4-2"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.054"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.10.010"},{"key":"e_1_3_3_18_2","unstructured":"Food and Drug Administration. BETAPACE AF\u00ae (sotalol HCl). Access December 13 2022. 2011. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2011\/021151s010lbl.pdf"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-017-0580-8"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2017.01.017"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054686"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2010.01764.x"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2018.08.025"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.06.018"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021375"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021328"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000121736.16643.11"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019406"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.03.337"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.114.001499"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/1074248410377618"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjp.0704106"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/1074248407306906"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021328"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.270.21.2590"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.123.011893","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:18:31Z","timestamp":1715563111000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.123.011893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1161\/CIRCEP.123.011893"],"URL":"https:\/\/doi.org\/10.1161\/circep.123.011893","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"2023-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}