Key result
Effective rhythm control maintaining sinus rhythm did not improve prognosis compared to rate control, with the primary composite endpoint occurring in 22.4% vs 15.2% of patients.
Why the study?
Does effective rhythm control improve prognosis compared to rate control in patients with persistent atrial fibrillation on continuous oral anticoagulation?
RCT (n=227)
Does effective rhythm control improve prognosis compared to rate control in patients with persistent atrial fibrillation on continuous oral anticoagulation?
Absolute Event Rate: 22.4% vs 15.2%
Maintaining sinus rhythm with a rhythm-control strategy does not confer a prognostic advantage over a rate-control strategy in patients with persistent atrial fibrillation on continuous oral anticoagulation.
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May support rhythm control in AF patients maintaining sinus rhythm; leaves open whether strategy improves outcomes versus rate control.
Rienstra et al. (2005) conducted an RCT in persistent atrial fibrillation (n=227). Effective rhythm control (long-term sinus rhythm) vs. Rate control (remaining in AF) was evaluated on composite of cardiovascular mortality, heart failure, thrombo-embolic complications (TECs), bleeding, serious adverse effects of antiarrhythmic drugs and pacemaker implants. Effective rhythm control maintaining sinus rhythm did not improve prognosis compared to rate control, with the primary composite endpoint occurring in 22.4% vs 15.2% of patients.
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