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September 12, 2022Circulation125 citationsOpen Access

Early Rhythm Control in Patients With Atrial Fibrillation and High Comorbidity Burden

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ARAndreas RilligKBKatrin BorofGBGünter Breithardt

Key Result

Early rhythm control in patients with atrial fibrillation and a -VASc score ≥4 reduces cardiovascular outcomes, with a significant difference in the primary safety outcome (P=0.044).

Study Design

Type

RCT

Structured PICO

Does early rhythm control reduce adverse cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and high comorbidity burden?

P
Population
Patients with recently diagnosed atrial fibrillation and stroke risk factors
I
Intervention
Early rhythm control (ERC)
O
Outcome
Adverse cardiovascular outcomes and primary safety outcomesafety

Early rhythm control may be particularly beneficial for reducing cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and a CHA2DS2-VASc score ≥4.

Main Result

p-value: p==0.044

Abstract

BACKGROUND: The randomized EAST-AFNET4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial-Atrial Fibrillation Network) demonstrated that early rhythm control (ERC) reduces adverse cardiovascular outcomes in patients with recently diagnosed atrial fibrillation and stroke risk factors. The effectiveness and safety of ERC in patients with multiple cardiovascular comorbidities is not known. METHODS: -VA score). RESULTS: =0.044) for the primary safety outcome. CONCLUSIONS: -VASc score ≥4 should be considered for ERC to reduce cardiovascular outcomes, whereas those with fewer comorbidities may have less favorable outcomes with ERC. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01288352. URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2010-021258-20. URL: https://www.isrctn.com/; Unique identifier: ISRCTN04708680.

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Cite This Study

Rillig et al. (2022) conducted an RCT in Atrial fibrillation and high comorbidity burden. Early rhythm control (ERC) was evaluated on Primary safety outcome (p==0.044). Early rhythm control in patients with atrial fibrillation and a -VASc score ≥4 reduces cardiovascular outcomes, with a significant difference in the primary safety outcome (P=0.044).

synapsesocial.com/papers/6a0663733f8bf83a443ddad7https://doi.org/10.1161/circulationaha.122.060274
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