To Compare The Efficacy And Safety Of Dronedarone Hydrochloride And Amiodarone In Preventing Early Recurrence Of Atrial Fibrillation After Radiofrequency Ablation In Elderly Patients

Objective To compare the efficacy and safety of dronedarone hydrochloride and amiodarone in preventing early recurrence of atrial fibrillation after radiofrequency ablation in elderly patients.Methods The clinical data of elderly patients who underwent the first radiofrequency catheter ablation of atrial fibrillation in the Department of Cardiology,Inner Mongolia Autonomous Region People’s Hospital from March 2021 to September 2022 were retrospectively analyzed.According to the different antiarrhythmic drugs taken within 3 months after the procedure,the patients were divided into the dronedarone hydrochloride group and the amiodarone group.The basic clinical data of the two groups were analyzed and compared,and the recurrence and related adverse reactions within 1 month and 3 months after operation were compared between the two groups.Results Clinical data of 169 elderly patients(age ≥60 years)with atrial fibrillation were collected in this study,including 87 patients in the dronedarone hydrochloride group and 82 patients in the amiodarone group.(1)There were significant differences in gender,age,BMI,smoking history,drinking history,type of atrial fibrillation,course of disease,history of hypertension,history of diabetes,history of peripheral vascular disease,and stroke /TIA between dronedarone hydrochloride group and amiodarone group There were no significant differences in medical history,organic heart disease history,hyperlipidemia,TC,LDL-C,LAD,LVEF,CRP,NT-Pro BNP,and other medication history between the two groups(P > 0.05).(2)The total recurrence rate of dronedarone hydrochloride group was higher than that of amiodarone group at 1 month and 3 months after operation(27.6% vs.13.4%,P < 0.05),but there was no significant difference between the two groups at 1 month and 3 months after operation(P=0.146,P=0.117).Using dronedarone hydrochloride or amiodarone as a covariate and recurrence as an endpoint event,the univariate Cox proportional hazards model analysis showed that: The regression coefficient of the dronedarone hydrochloride group was 0.755,and the regression coefficient of the amiodarone group was-0.755,that is,the risk of early postoperative recurrence in the amiodarone group was lower than that in the dronedarone hydrochloride group,and the risk of early postoperative recurrence in the elderly patients with atrial fibrillation treated with dronedarone hydrochloride was 2.128 times higher than that in the amiodarone group(OR: 2.128,95%CI: 1.042-4.343,P=0.038).(3)The total incidence of adverse reactions at 1 month and 3 months after operation in the amiodarone group(46.3%)was higher than that in the dronedarone hydrochloride group(21.8%),and the difference was statistically significant(P=0.001).Among them,18 cases(22.0%)in amiodarone group had abnormal liver function,which was higher than 3 cases(3.4%)in dronedarone hydrochloride group,and the difference was statistically significant(P=0.001).The incidence of thyroid dysfunction in amiodarone group(17 cases,20.7%)was higher than that in dronedarone group(2 cases,2.3%),and the difference was statistically significant(P <0.001).The incidence of gastrointestinal adverse reactions in the dronedarone hydrochloride group was 11.5%,which was higher than that in the amiodarone group(2.4%,P=0.046).Within the first month after surgery,the patients with abnormal liver function and thyroid function in the amiodarone group were higher than those in the dronedarone hydrochloride group,the difference was statistically significant(P=0.009,P=0.009),and the patients with gastrointestinal adverse reactions were lower than those in the dronedarone hydrochloride group(P=0.017).Within 3 months after operation,the patients with abnormal liver function and thyroid function in the amiodarone group were still higher than those in the dronedarone hydrochloride group,and the difference was statistically significant(P=0.015,P=0.005).(4)The incidence of gastrointestinal adverse reactions in the dronedarone hydrochloride group in the first month after surgery(11.5%)was higher than that in the third month after surgery(0.0%),and the difference was statistically significant(P < 0.001).Conclusion(1)Dronedarone hydrochloride is less effective than amiodarone in preventing early recurrence of atrial fibrillation after radiofrequency ablation in elderly patients.(2)Compared with amiodarone,dronedarone hydrochloride has a lower incidence of adverse reactions and higher safety in the early application of elderly patients with atrial fibrillation after radiofrequency ablation.