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决奈达隆为新型苯并呋喃衍生物,结构与胺碘酮相似。决奈达隆具有多通道阻滞的电生理特性。Ⅲ期临床试验证实,决奈达隆能有效减少心房颤动(Af)或心房扑动(AF)的复发,减慢Af/AF的心室率,减低心血管发病率及病死率。但在一项纳入重度心力衰竭(HF)及左室功能障碍患者的研究中,决奈达隆使病死率升高。决奈达隆耐受性好,不明显延长QTc间期,无显著肺、甲状腺、肝、眼和神经系统毒性,最常见的不良反应为腹泻、恶心及呕吐。决奈达隆可选择性用于Af/AF的治疗。但在预防Af复发时,决奈达隆疗效逊于胺碘酮,尚需更多有关决奈达隆与胺碘酮疗效的对比研究以确立决奈达隆在治疗中的地位。
Dronedarone is a novel benzofuran derivative with similar structure to amiodarone. Dronedarone has multi-channel blockade of electrophysiological properties. Phase III clinical trials confirmed that dronedarone can effectively reduce the recurrence of atrial fibrillation (AF) or atrial flutter (AF), slow down the ventricular rate of Af / AF, reduce cardiovascular morbidity and mortality. However, in a study involving patients with severe heart failure (HF) and left ventricular dysfunction, dronedarone resulted in an increased mortality. Dronedarone was well tolerated, with no significant prolongation of QTc interval and no significant pulmonary, thyroid, hepatic, ocular and neurotoxicity. The most common adverse reactions were diarrhea, nausea and vomiting. Dronedarone is optionally available for the treatment of Af / AF. However, dronedarone is less effective than amiodarone in preventing the recurrence of Af, and more research on the efficacy of dronedarone versus amiodarone is needed to establish the status of dronedarone in treatment.