rate control strategy
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2016 May 19;374(20):1911-21 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, paroxystic, after cardiac surgery, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To modify hospital stay, death, thromboembolic and bleeding events. At 60 days, 94% in rate control and 98% in rhythm control were in sinus rythm.
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 improve cost-effectiveness: rate control is always more effective and less costly
Arch Cardiovasc Dis. 2012 Apr;105(4):226-38 Meta-Analysis
IN atrial fibrillation, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To modify mortality, stroke, embolism or major bleeding
Pacing Clin Electrophysiol. 2013 Jan;36(1):122-33 Meta-Analysis
IN atrial fibrillation, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To rate control carried fewer hospitalizations with no differences in mortality or other outcomes. In 5 studies with few patients (50 to 250, 650 patients total) conducted in patients <65 years old, rate control was associated with higher mortality
Br J Clin Pharmacol. 2005 Oct;60(4):347-54 Meta-Analysis
IN atrial fibrillation, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control strategy (cardioversion and antiarrhythmics)
To reduce adverse effects and hospitalizations. Complications of AF: death, ischaemic stroke and non-CNS bleeding were similar.
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003713 Systematic Review, Cochrane Review
IN atrial fibrillation, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control strategy using pharmacologic cardioversion and antiarrhythmics
To reduce complications of AF: mortality was similar, rhythm control associated more adverse effects and hospitalisations
Am J Med. 2013 Oct;126(10):887-93 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, rate control strategy, older patients The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control strategy
To improve overall mortality at 3.4 years : 18% in rate control VS 23% in rhythm control
Ann Intern Med. 2014 Jun 03;160(11):760-73 Systematic Review
IN atrial fibrillation, rate control strategy, older patients with mild AF symptoms The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control strategy
To modify all cause mortality, cardiac mortality or stroke
N Engl J Med. 2008 Jun 19;358(25):2667-77 Randomized Controlled Trial, Multicenter Study
IN Study ID: AF-CHF 2008, 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)
Circ J. 2009 Feb;73(2):242-8 Randomized Controlled Trial
IN Study ID: J-RHYTHM 2009, atrial fibrillation, persistent, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control
To modify mortality and cardiovascular morbidity at 1.5 years
N Engl J Med. 2002 Dec 5;347(23):1825-33 Randomized Controlled Trial
IN StudyID: AFFIRM 2002, atrial fibrillation, rate control strategy The Use of
rate control strategy (drugs and anticoagulation)
As Treatment, Chronic
Is equal Than
rhythm control strategy (cardioversion and antiarrhythmics, anticoagulation recommended)
To overall mortality: 4,26%/year in rate-c vs 4,76%/year in rhythm-c. More patients in rhythm-c were hospitalized and suffered adverse drug effects
Arch Intern Med. 2005 Feb 14;165(3):258-62 Meta-Analysis
IN StudyID: Denus 2005, atrial fibrillation, rate control strategy The Use of
rate control strategy (drugs and anticoagulation)
As Treatment, Chronic
Is equal Than
rhythm control strategy (cardioversion and antiarrhythmics)
To reduce all-cause mortality: 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
N Engl J Med. 2002 Dec 5;347(23):1834-40 Randomized Controlled Trial
IN StudyID: RACE 2002, atrial fibrillation, rate control strategy The Use of
rate control strategy (drugs and anticoagulation)
As Treatment, Chronic
Is equal Than
rhythm control strategy (electrical cardioversion and antiarrhythmics, anticoagulation recommended)
To combined events (cardiovascular death, heart failure, any embolism, bleeding, severe drug adverse effects, pacemaker): 3,44%/year in rate-c vs 4,52%/year in rhythm-c. Patients in sinus rhythm at 2,3 years were 10% in rate-c vs 39% in rhythm-c
J Am Coll Cardiol. 2003 May 21;41(10):1690-6 Randomized Controlled Trial
IN StudyID: STAF 2003, atrial fibrillation, rate control strategy The Use of
rate control strategy (pharmacologic or invasive rate-control and anticoagulation)
As Treatment, Chronic
Is equal Than
rhythm control strategy (restoration and maintenance of sinus rhythm)
To combined major cardiovascular events (death, heart arrest, stroke, and systemic embolism): 6.09%/year in rate-c vs 5.54%/year in rhythm-c. Patients in sinus rhythm at 3 years were 0% in rate-c vs 23% in rhythm-c
Eur Heart J. 2005 Oct;26(19):2000-6. Epub 2005 May 4 Meta-Analysis
IN StudyID: Testa 2005, 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.