Retrospective Analysis of Dronedarone Versus Amiodarone on Outcomes Following Radiofrequency Ablation for Atrial Fibrillation

Aims/Background: Pharmacological therapy can enhance the therapeutic efficacy of radiofrequency ablation (RFA) for atrial fibrillation (AF) and reduce the risk of recurrence. Dronedarone and amiodarone are two commonly prescribed adjuvant medications. However, no consensus exists on which agent demonstrates superior efficacy. This study aimed to compare the effects of dronedarone and amiodarone on the prognosis of patients undergoing RFA for AF, thereby providing evidence-based guidance for clinical medication selection. Methods: A retrospective analysis was conducted on AF patients who underwent RFA in Tianjin Fourth Central Hospital between August 2022 and May 2023. Patients were assigned to a dronedarone group (n = 50), and an amiodarone group (n = 59) based on the postoperative medication received. Postoperatively, patients were treated with either dronedarone hydrochloride tablets or amiodarone hydrochloride tablets for 6 months. Long-term electrocardiographic monitoring (7-day duration via 5G network) was performed at 1, 3, 6, and 12 months postoperatively to assess recurrence of atrial arrhythmias. Follow-up assessments at the same intervals included thyroid, liver, and renal function, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), and QT interval. Results: No statistically significant difference was observed in AF recurrence between the two groups (p > 0.05). The incidence of thyroid dysfunction was significantly lower in the dronedarone group compared with the amiodarone group (p < 0.05), whereas other adverse events showed no significant difference (p > 0.05). In both groups, postoperative LVEF was significantly higher than preoperative values (p < 0.05), and LAD was significantly reduced (p < 0.05). Comparing the two groups, postoperative LAD was significantly smaller in the dronedarone group than in the amiodarone group (p < 0.05), while postoperative LVEF exhibited no statistically significant difference (p > 0.05). Conclusion: Dronedarone and amiodarone are similarly effective in reducing the AF recurrence after RFA. However, dronedarone is associated with a lower risk of thyroid dysfunction and confers greater improvement in left atrial remodelling.