Effects of Dronedarone on Cardiac Geometry and Function in Patients With Atrial Fibrillation and Left Atrial Enlargement
Condition: Atrial Fibrillation
MeSH terms: Atrial Fibrillation
Intervention: Dronedarone; Placebo (for Dronedarone)
Intervention description: Film-coated tablet
Oral administration under fed conditions (during breakfast and dinner); film-coated tablet strictly identical in appearance
Oral administration under fed conditions (during breakfast and dinner)
Intervention MeSH terms: Dronedarone
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Enrollment: 76.0
Sex: All
Minimum age: 21 Years
Healthy volunteers: No

Summary:

      Primary Objective:

      - Evaluate the effect of dronedarone versus placebo (standard therapy) in slowing the
      progression of adverse left atrial remodeling in patients with atrial fibrillation (AF)
      following 12 months of treatment.

      Secondary Objectives:

        -  Evaluate the effects of dronedarone versus placebo on left atrial function;

        -  Evaluate the effects of dronedarone versus placebo on left atrial dimension;

        -  Evaluate the effects of dronedarone versus placebo on left ventricular function (LVEF,
           E, E', A, E/E')

        -  Evaluate the safety and tolerability of dronedarone.
    

Eligibility criteria:

        Inclusion criteria:

          -  Signed written informed consent and Health Insurance Portability and Accountability
             Act (HIPAA) Authorization;

          -  Nonpermanent AF or AF/Atrial Flutter (AFL) documented electrocardiographically by both
             AF (or AF/AFL) and sinus rhythm within the prior 12 months;

          -  At screening, sinus rhythm and Left Atrial Volume index (LAVi) ≥32 mL/m2 based on
             2D-echocardiography;

          -  At least one of the following cardiovascular (CV) risk factors: Age >70 years at start
             of screening, hypertension, diabetes mellitus, prior CV accident (stroke or transient
             ischemic attack) or systemic embolism, or left ventricular ejection fraction <0.40.

        Exclusion criteria:

          -  Permanent AF defined as continuous AF for 6 months or longer;

          -  Persistent AF defined as sustained AF >7 days duration and/or requiring cardioversion
             in the 4 weeks before screening;

          -  Prior valvular heart surgery or significant valvular heart disease including rheumatic
             heart disease or acquired valvular heart disease;

          -  Aortic or mitral regurgitation greater than mild (>1+) or any degree of mitral
             stenosis at the screening echocardiogram;

          -  Myocardial infarction within the 6 months prior to screening or stroke within 2 months
             prior to screening;

          -  Pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization
             therapy devices placed within the 6 months prior to screening or at anytime during the
             study;

          -  Ongoing potentially dangerous symptoms when in AF/AFL such as angina pectoris,
             transient ischemic attacks, stroke, syncope as judged by the Investigator;

          -  Cardiac ablative procedure or cardiac surgery within 3 months prior to screening, or
             percutaneous coronary intervention within 4 weeks prior to screening;

          -  Need for concomitant medication that is prohibited in this trial, and would preclude
             the use of the study drug during the planned study period including the following:

               -  Antiarrhythmics (eg, amiodarone, flecainide, propafenone, quinidine,
                  disopyramide, dofetilide, sotalol);

               -  Drugs or products that are strong inhibitors of CYP3A (eg, ketoconazole,
                  itraconazole, voriconazole, cyclosporine, telithromycin, clarithromycin,
                  nefazodone, ritonavir, and grapefruit juice);

               -  Drugs that are inducers of CYP3A (eg, rifampin, phenobarbital, carbamazepine,
                  phenytoin, and St John's wort);

          -  QTc Bazett interval ≥500 msec on the screening ECG;

          -  Bradycardia <50 bpm and/or PR interval ≥0.28 sec on the screening ECG unless the
             patient has a functional pacemaker;

          -  New York Heart Association (NYHA) Class IV heart failure or NYHA Class II or III heart
             failure with a recent decompensation requiring hospitalization or referral to a
             specialized heart failure clinic within 4 weeks prior to screening.

        The above information is not intended to contain all considerations relevant to a patient's
        potential participation in a clinical trial.