Key result
In hypertensive patients with persistent atrial fibrillation, rhythm control was associated with higher cardiovascular morbidity and mortality compared to rate control (13.3 vs 7.2 per 100 person-years; P=0.02).
Why the study?
Does a rhythm control strategy compared to rate control improve cardiovascular morbidity and mortality in patients with persistent atrial fibrillation and hypertension?
RCT (n=522)
randomized
Does a rhythm control strategy compared to rate control improve cardiovascular morbidity and mortality in patients with persistent atrial fibrillation and hypertension?
Relative Risk: 0.5 (95% CI 0.3–0.9)
Absolute Event Rate: 13.3% vs 7.2%
p-value: p=0.02
In patients with persistent atrial fibrillation and hypertension, a rhythm control strategy is associated with higher cardiovascular morbidity and mortality compared to rate control.
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Caution against rhythm control in hypertensive persistent AF; challenges prior evidence supporting rhythm restoration.
Rienstra et al. (2007) conducted an RCT in persistent atrial fibrillation (AF) (n=522). Rhythm control vs. Rate control was evaluated on cardiovascular morbidity and mortality (relative risk 0.5, 95% CI 0.3-0.9, p=0.02). In hypertensive patients with persistent atrial fibrillation, rhythm control was associated with higher cardiovascular morbidity and mortality compared to rate control (13.3 vs 7.2 per 100 person-years; P=0.02).
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