Electrophysiology
AF management, anticoagulation, and rhythm control
Also called AF, AFib, A-fib, atrial fib
Sources: updated Oct 8, 2026
Specific, answerable questions in this area — each with its own synthesized evidence and consensus. Open one to see the forest plot, source trials, and how the consensus has changed over time.
dabigatran vs Warfarin · Major Bleeding
Synthesized from 20 evidence-backed clinical questions on Atrial fibrillation — 13 supports benefit, 7 no benefit shown.
The placed evidence leans toward benefit
13
Favor benefit
65% of all
7
No benefit shown
35% of all
Low certainty on 100% of questions
Does vitamin k antagonist vs placebo improve outcomes in Atrial Fibrillation?
Low Certainty+ Favors benefitvitamin k antagonist vs placebo · Cardiac Index
85 studies (10,879,265 patients, 1 RCTs) provide low-certainty evidence for benefit of vitamin k antagonist for Cardiac Index in Atrial Fibrillation.
Does antiarrhythmic drugs vs placebo improve outcomes in Atrial Fibrillation?
Low Certainty− No benefit shownantiarrhythmic drugs vs placebo · Cardiac Output
136 studies (1,207,614 patients, 1 RCTs) provide low-certainty evidence against benefit of antiarrhythmic drugs for Cardiac Output in Atrial Fibrillation.
CABANA and EARLY-AF
Cardiology Trials Journal Club — Tue, Sep 15, 10:00 AM EDT
AFFIRM and RACE
Cardiology Trials Journal Club — Tue, Sep 8, 10:00 AM EDT
SAFE-T and RACE II
Cardiology Trials Journal Club — Tue, Sep 1, 10:00 AM EDT
ANDROMEDA, ATHENA and PALLAS
Cardiology Trials Journal Club — Tue, Aug 25, 10:00 AM EDT
#bruinhearts VA Journal Club--NEMESIS PFA
UCLA #bruinhearts Journal Club Section — Fri, Aug 21, 11:00 AM EDT — 2 attended
VA Journal Club: Factor XI Inhibitors and Atrial Fibrillation
UCLA #bruinhearts Journal Club Section — Fri, Aug 7, 11:00 AM EDT
Sessions from public journal clubs on Synapse. RSVP to join the live discussion.
A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.
Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.
Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.
The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.
“If you can suppress AFib for six months to a year with an antiarrhythmic drug and you can get a patient maybe to lose a little weight or decrease their alcohol content or just give it time. A lot of times, you can take people off antiarrhythmic drugs and the A fib doesn't come back.”
“For older, minimally symptomatic atrial fibrillation patients, rhythm control does not improve survival compared with rate control and requires continued anticoagulation.”
“The SAFE-T trial demonstrated amiodarone's superiority over sotalol for rhythm maintenance, but intention-to-treat quality-of-life benefits remained neutral.”
University of North Carolina at Chapel Hill
h-index 128 · 63k citations
Most-cited researchers publishing on Atrial fibrillation.
