Key result
A routine strategy of rhythm control did not significantly reduce the rate of death from cardiovascular causes compared with rate control in patients with atrial fibrillation and heart failure.
Why the study?
Does a rhythm-control strategy reduce cardiovascular death compared to a rate-control strategy in patients with atrial fibrillation and heart failure?
Does a rhythm-control strategy reduce cardiovascular death compared to a rate-control strategy in patients with atrial fibrillation and heart failure?
A routine strategy of rhythm control does not reduce the rate of death compared to rate control in patients with atrial fibrillation and heart failure, suggesting rate control should be considered a primary approach.
Rhythm control does not reduce CV death versus rate control in AF with HF; leaves open optimal strategy in contemporary cohorts.
PURPOSE OF REVIEW: The present review will examine the prognostic importance of atrial fibrillation and heart failure, explore the different therapeutic options for treating atrial fibrillation and present the results of the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. RECENT FINDINGS: The Atrial Fibrillation and Congestive Heart Failure trial was a randomized trial involving patients with both atrial fibrillation and heart failure. The trial was designed to compare the maintenance of sinus rhythm with the control of ventricular rate in patients with left ventricular dysfunction, heart failure and a history of atrial fibrillation. There was no significant difference in the rate of death from cardiovascular causes in the rhythm-control group as compared with the rate-control strategy. In addition, there was no significant difference in any of the secondary outcomes including death from any cause, worsening heart failure or stroke. The rate-control strategy eliminated the need for repeated cardioversion and reduced rates of hospitalization. SUMMARY: The results of the Atrial Fibrillation and Congestive Heart Failure trial indicate that a routine strategy of rhythm control does not reduce rate of death and suggest that rate control should be considered a primary approach for patients with atrial fibrillation and heart failure.
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Roy et al. (2008) conducted a review in Atrial fibrillation and congestive heart failure. Rhythm control vs. Rate control was evaluated on Death from cardiovascular causes. A routine strategy of rhythm control did not significantly reduce the rate of death from cardiovascular causes compared with rate control in patients with atrial fibrillation and heart failure.
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