We recommend that dronedarone not be used in patients with permanent AF nor for the sole purpose of rate control. (Recommendation Strong, Quality High)<br /><br />We recommend dronedarone not be used in patients with a history of heart failure or a left ventricular ejection fraction &lt; 40%. (Recommendation Strong, Quality Moderate)<br /><br />We suggest dronedarone be used with caution in patients taking digoxin. (Recommendation Strong, Quality Moderate)<br /><br /><b>Values and Preferences: </b>These recommendations recognize that the mechanism(s) for the differences between the results of the ATHENA and the PALLAS trials have not yet been determined. These recommendations are based on the known differences between the two patient populations and are also informed by the results of the ANDROMEDA trial.