Why the study?
Does a rhythm control strategy improve therapeutic success compared to a rate control strategy in patients with recent-onset atrial fibrillation?
Observational (n=303)
Yes
Does a rhythm control strategy improve therapeutic success compared to a rate control strategy in patients with recent-onset atrial fibrillation?
Answers are grounded in this paper and cite their sources.
In a real-world Polish registry of recent-onset atrial fibrillation, a rhythm-control strategy was associated with better AF control and slower progression to permanent AF compared to rate control, though cardiovascular event rates were similar.
INTRODUCTION: Data on real-life management of atrial fibrillation (AF) in Poland is limited. OBJECTIVES: To present data on 1-year follow-up of patients from Poland included in a worldwide registry on patients with AF (RecordAF). PATIENTS AND METHODS: Patients with recent onset AF were included (n=303). Treatment strategy (rhythm or rate control) was noted at baseline. Therapeutic success (control of AF, with no incidence of cardiovascular events and no switch between the strategies) was assessed after one year. RESULTS: Data from 289 patients were assessable. A rhythm control strategy was noted in 70% of patients. Rhythm control patients received anti-thrombotic therapy less frequently than rate control patients (90.4% vs. 97.6%) but more often received class I (19.8% vs. 4.8%) and class III (20.8% vs. 4.8%) antiarrhythmic drugs (p<0.05 for all comparisons). Therapeutic success was noted in 71.5% of rhythm control patients vs. 29.1% of rate control patients (p<0.0001), a result driven by control of AF (89.3% in the rhythm control group vs. 56.1% in the rate control group, p<0.0001). The rate of cardiovascular events was similar in both groups (20.6% of all patients). Progression to permanent AF occurred in 5.9% of rhythm control patients vs. 73.2% of rate control patients (p<0.001). CONCLUSIONS: Most of the patients received thromboembolic prevention and the majority was assigned to rhythm control. Despite infrequent use of anti-arrhythmic drugs, a rhythm control strategy was associated with better AF control and slower progression but not with lower rate of cardiovascular events in patients with recent-onset AF in Poland.
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Opolski et al. (2013) conducted an observational in Newly diagnosed atrial fibrillation (n=303). Rhythm-control strategy vs. Rate-control strategy was evaluated on Therapeutic success at 1 year (defined as being in sinus rhythm or at rate control target ≤80 beats/min at rest, with no major cardiovascular events and no crossover between strategies) (p=<0.0001).
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