The antiarrhythmic drug dronedarone (Multaq) was developed as a replacement for amiodarone (Cordarone) which has the potential for causing serious adverse effects such as thyrotoxicosis, pulmonary failure and liver failure. Early trials showed dronedarone to be significantly less effective than amiodarone, but possibly somewhat safer. A recent German trial concludes that dronedarone is not only almost totally ineffective (keeping only 20% of patients taking it in normal sinus rhythm), but also has the potential to cause serious side effects including bradycardia, atrioventricular block, QT interval prolongation and gastrointestinal problems (32% of patients discontinued the drug because of adverse effects).

The main difference between amiodarone and dronedarone is that amiodarone contains 39% by weight of iodine. Thus a patient taking 200 mg/day of amiodarone would ingest 78 mg/day of iodine or about 500 times the recommended daily allowance of 150 micrograms. Is it possible that amiodarone owes much of its efficacy to its iodine component and that supplementing with safe amounts of iodine would be beneficial for afibbers?

Also in this issue we report that a right atrial flutter ablation on its own is a waste of time when trying to deal with coexisting atrial fibrillation and atrial flutter, that the LARIAT procedure for closing off the left atrial appendage has been found safe and effective, that Chinese EPs have been successful in the first trial of a simpler variant of the standard pulmonary vein isolation procedure, and that Danish researchers have found that a long QT interval is a potent risk factor for the development of lone atrial fibrillation.

Last but not least, if you need to restock your supplements, please remember that by ordering through my on-line vitamin store you will be helping to defray the cost of maintaining the web site and bulletin board. You can find the store at http://www.afibbers.org/vitamins.htm - your continuing support is greatly appreciated.

Wishing you good health and lots of NSR,