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The following is a summary of “Health Care Resource Utilization With Dronedarone Versus Sotalol Following Catheter Ablation in Adults With Atrial Fibrillation,” published in the January 2025 issue of Cardiology by Zeitler et al. 

Researchers conducted a retrospective study to compare the health care resource utilization (HCRU) of dronedarone with other antiarrhythmic drugs for atrial fibrillation (AF) after catheter ablation (CA).  

They analyzed Merative MarketScan databases (January 1, 2012–March 31, 2020) to compare HCRU in US adults with AF who received dronedarone or sotalol post-CA. Patients with ≥12 months of pre-CA data were followed from post-CA index treatment until disenrollment, death, or study end. Propensity score matching (1:1) was performed for sotalol-treated patients with dronedarone-treated patients. Events per 100 patient-years (PY) were analyzed using a univariate generalized linear model with Poisson distribution. Kaplan–Meier methods analyzed cumulative incidence over 12 months. Subgroup analyses were conducted by sex and whether patients were new to dronedarone or sotalol during the 12 months before CA.  

The results showed that dronedarone and sotalol cohorts were successfully matched (n = 1600 each). Prevalence per 100 PY for all-cause, cardiovascular (CV)-related, and atrial tachyarrhythmia (ATA)/AF-related HCRU was lower in the dronedarone cohort compared to the sotalol cohort (all P < 0.05). Cumulative incidence for all-cause, CV-related, and ATA/AF-related hospitalizations, as well as pacemaker implantation, was also lower in the dronedarone cohort (all P < 0.05). After rematching, all-cause and CV-related hospitalization rates were lower for both females (n = 460) and males (n = 1115) in the dronedarone cohort (all P < 0.05). The incidence of ATA/AF-related hospitalization was lower in males compared to females receiving dronedarone. For patients new to dronedarone or sotalol (n = 549), HCRU results were consistent with primary findings.  

Investigators concluded that post-cardioversion, dronedarone demonstrated a lower risk of CV-related hospitalizations compared to sotalol in patients with AF, including both male and female subgroups, suggesting that these findings might inform clinical decision-making regarding post-cardioversion antiarrhythmic drug selection in this patient population. 

Source: onlinelibrary.wiley.com/doi/full/10.1002/clc.70064