Why the study?
Does aggressive upstream rhythm control improve maintenance of sinus rhythm compared to conventional rhythm control in patients with early atrial fibrillation and heart failure?
Does aggressive upstream rhythm control improve maintenance of sinus rhythm compared to conventional rhythm control in patients with early atrial fibrillation and heart failure?
The RACE 3 trial is designed to evaluate whether aggressive upstream rhythm control, including medical therapy and lifestyle interventions, improves the maintenance of sinus rhythm in patients with early atrial fibrillation and heart failure.
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Trial tests upstream rhythm control plus lifestyle interventions in early AF-HF; leaves open whether this outperforms conventional strategies.
RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.
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Alings et al. (2013) studied this question.
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