Key result
Early rhythm control reduces cardiovascular outcomes and improves safety in AF with CHA2DS2-VASc ≥4.
Why the study?
The effectiveness and safety of early rhythm control in patients with recently diagnosed atrial fibrillation, stroke risk factors, and multiple cardiovascular comorbidities is not known.
Does early rhythm control reduce adverse cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and high comorbidity burden?
RCT
Does early rhythm control reduce adverse cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and high comorbidity burden?
p-value: p==0.044
Early rhythm control may be particularly beneficial for reducing cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and a CHA2DS2-VASc score ≥4.
May support early rhythm control in AF with CHA2DS2-VASc ≥4; leaves open confirmation in prospective trials.
BACKGROUND: The randomized EAST-AFNET4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial-Atrial Fibrillation Network) demonstrated that early rhythm control (ERC) reduces adverse cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and stroke risk factors. The effectiveness and safety of ERC in patients with multiple cardiovascular comorbidities is not known. METHODS: -VA score). RESULTS: =0.044) for the primary safety outcome. CONCLUSIONS: -VASc score ≥4 should be considered for ERC to reduce cardiovascular outcomes, whereas those with fewer comorbidities may have less favorable outcomes with ERC. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01288352. URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2010-021258-20. URL: https://www.isrctn.com/; Unique identifier: ISRCTN04708680.
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Rillig et al. (2022) conducted an RCT in Atrial fibrillation and high comorbidity burden. Early rhythm control (ERC) was evaluated on Primary safety outcome (p==0.044). Early rhythm control in patients with atrial fibrillation and a -VASc score ≥4 reduces cardiovascular outcomes, with a significant difference in the primary safety outcome (P=0.044).
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