Key result
Rhythm-control shows no benefit over rate-control for major cardiovascular events.
Why the study?
It was unclear whether a strategy of rhythm- or rate-control is better in terms of mortality, morbidity, and quality of life in patients with atrial fibrillation.
Does a rhythm-control strategy reduce the composite of death, cardiopulmonary resuscitation, cerebrovascular event, and systemic embolism in patients with persistent atrial fibrillation compared to a rate-control strategy?
RCT (n=200)
randomized
Yes
Does a rhythm-control strategy reduce the composite of death, cardiopulmonary resuscitation, cerebrovascular event, and systemic embolism in patients with persistent atrial fibrillation compared to a rate-control strategy?
Absolute Event Rate: 9% vs 10%
p-value: p=0.99
In patients with persistent atrial fibrillation, a rhythm-control strategy showed no significant difference in the composite of death, CPR, cerebrovascular event, and systemic embolism compared to a rate-control strategy.
No takes yet. Share an insight, caveat, or question.
Should not yet change AF management; leaves open optimal strategy pending larger confirmatory trials.
Carlsson et al. (2003) conducted an RCT in persistent atrial fibrillation (n=200). Rhythm-control vs. Rate-control was evaluated on combination of death, cardiopulmonary resuscitation, cerebrovascular event, and systemic embolism (p=0.99). Rhythm-control was not significantly different from rate-control for the composite of death, cardiopulmonary resuscitation, cerebrovascular event, and systemic embolism (9% vs 10%; p=0.99).
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