Meta-analysis: Rhythm control versus rate control
DISEASE INTERVENTION COMPARISON RESULTS
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
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
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
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.