Atrial fibrillation: Rhythm control versus rate control strategy
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2002 Dec 5;347(23):1834-40 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, persistent, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To reduce a composite of cardiovascular and treatment-related events: 17.2% in rate-control VS 22.6% in rhythm-control
Arch Intern Med. 2005 Feb 14;165(3):258-62 Meta-Analysis
IN atrial fibrillation, persistent, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To reduce all-cause mortality at 2 to 3.5 years: 14.6% rhythm-control vs 13.0% rate-control. A trend existed in favour of rate-control: OR 0.87; 95%CI 0.74-1.02
Ann Intern Med. 2004 Nov 2;141(9):653-61 Cost-Effectiveness
IN atrial fibrillation, persistent, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control strategy
To cost-effectiveness: rate control is always more effective and less costly
N Engl J Med. 2002 Dec 5;347(23):1825-33 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control
To reduce adverse drug effects and hospital admissions, while no difference in mortality (23.8% rate VS 21.3% rhythm control at 5 years)
Eur Heart J. 2005 Oct;26(19):2000-6. Epub 2005 May 4 Meta-Analysis
IN atrial fibrillation, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control strategy
To reduce a combined endpoint of all cause death and thromboembolic stroke (OR 0.84 (0.73, 0.98)). No difference in all-cause death, systemic embolism and major bleeding.
N Engl J Med. 2008 Jun 19;358(25):2667-77 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, rate control strategy, heart failure, chronic, systolic The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To modify death from cardiovascular causes (25% rate-control VS 27% rhythm-control) or reduce stroke (4% rate-control VS 3% rhythm-control) or worsening heart failure (31% rate-control VS 28% rhythm-control)