Rate and rhythm control have comparable effects on mortality and stroke in atrial fibrillation but better data are needed

Commentary on : Al-Khatib SM, Allen LaPointe NM, Chatterjee R, et al. Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review. Ann Intern Med 2014;160:760–73.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Atrial fibrillation (AF) represents a large and growing burden on cardiovascular healthcare and leads to a substantial impact on quality-of-life, increased cardiovascular events and a doubling of hospitalisation and death rates.1 Unlike many other cardiac conditions, the evidence base for treatment in AF remains patchy with clear gaps relating to a number of clinically important management strategies. Current practice involves three major elements: anticoagulation to prevent stroke or systemic embolism, medications to control heart rate and a decision on whether to restore and maintain sinus rhythm. This systematic review and meta-analysis of tabular data addresses the benefits and risks of adding rhythm control to rate control therapy, considers the preferential method … [1]: {openurl}?query=rft.jtitle%253DAnn%2BIntern%2BMed%26rft.volume%253D160%26rft.spage%253D760%26rft_id%253Dinfo%253Adoi%252F10.7326%252FM13-1467%26rft_id%253Dinfo%253Apmid%252F24887617%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.7326/M13-1467&link_type=DOI [3]: /lookup/external-ref?access_num=24887617&link_type=MED&atom=%2Febmed%2F19%2F6%2F222.atom [4]: /lookup/external-ref?access_num=000337348700003&link_type=ISI