Dronedarone is an amiodarone analogue (with fewer adverse side effects than amiodarone), which has been shown to reduce atrial fibrillation recurrence compared to placebo, but long term safety had not been established. In this large RCT of >4000 patients, patients on dronedarone had lower cardiac hospitalizations and death than those on placebo (after mean f/u of 21 months). There was no difference in the groups in pulmonary, liver, or thyroid toxicity, so this drug will likely replace some amiodarone in the management of patients with atrial fibrillation (abstract).
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