Are we at the Goal Line with the Novel Oral Anticoagulants and Have We Reached the End of the Line for Dronedarone and Vernakalant – or is There More to Come?

The authors of this Mini-Hot-Topic collection of review manuscripts have provided an outstanding review of the development and current status of several of our most recently developed agents in the fight against atrial fibrillation (AF). They have also given the readers a glimpse into the difficulty of drug development and the contrasts that can exist with the same product in different geographies. For their efforts they have my deepest appreciation. It is my hope that these articles will assist those of you who are clinicians in your care of patients and those of you who are investigators in your appreciation of the drug development process and its hurdles. More specifically, this Mini-Hot-Topic symposium has reviewed for you: (1) the evidence supporting the new novel oral anticoagulants (NOACs) as first-line therapy for preven-tion of stroke and systemic embolism in patients with “nonvalvular” atrial fibrillation (NVAF); (2) the winding path taken by dronedarone in reaching its current place in our antiarrhythmic armamentarium – in which it still has a role; and (3) the contrasting decisions made with respect to the marketing of vernakalant in Europe versus the United States. Now, in this last manuscript of the collection, I will echo for emphasis some of their highlights and I will also bring you further up to date with respect to a possible future role for dronedarone, as hinted at by the HARMONY trial.