Antiarrhythmic accepted for limited NHS use

NICE has approved dronedarone (Multaq) as a second-line treatment for certain patients with atrial fibrillation.

Dronedarone (Multaq) blocks multiple ion channels, lowering ventricular rate and preventing recurrence of atrial fibrillation.

The institute revised its original plan to reject dronedarone following a campaign by patients, healthcare professionals and MPs.

NHS use of the drug is restricted to patients whose atrial fibrillation cannot be controlled by first-line therapy (usually β-blockers), and who have at least one of the following risk factors:

•    diabetes
•    hypertension requiring treatment with at least two different drug classes
•    previous systemic embolism, stroke or TIA
•    left atrial diameter greater than 50mm
•    left ventricular ejection fraction of less than 40%
•    aged 70 years or older without NYHA class III or IV heart failure

People already receiving dronedarone who do not meet the above criteria should be able to continue treatment until they and their doctor decide it is appropriate to stop, says NICE.

NICE guidance on dronedarone

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