Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation

Carlsson, J.; Miketic, Sinisa; Windeler, Jürgen; Cuneo, Alessandro; Haun, S.; Micus, Stefan; Walter, Sabine; Tebbe, Ulrich; Investigators, Staf

doi:10.1016/s0735-1097(03)00332-2

Cited by 852 publications

(484 citation statements)

References 19 publications

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“…In the STAF study, scores on the SF-36 physical role function and mental health domains significantly improved from baseline to follow up (mean duration, 19.5 months) in the rhythm-control group (both P < 0.05), despite the fact that only 70% of patients were in sinus rhythm after cardioversion and only 23% at 36 months. 28 In the PIAF study, SF-36 scores for physical functioning, physical role function, vitality, and social functioning improved significantly from baseline to Month 12 in the rhythm-control group (all P < 0.05), despite the fact that only 56% of patients in this group remained in sinus rhythm at the 12-month timepoint. 47 In patients with AF and CHF, improvements in LV function have been described even for patients who did not achieve 100% suppression of AF.…”

Section: Treatment Expectations: Defining Treatment Goalsmentioning

confidence: 85%

Sinus Rhythm Restoration and Treatment Success: Insight From Recent Clinical Trials

Saliba

Wazni

2011

Clinical Cardiology

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Atrial fibrillation (AF) is a common supraventricular tachyarrhythmia with substantial morbidity and mortality. This review briefly describes the mechanisms of AF development and progression, including electrical, structural, and contractile remodeling. In addition, the potential benefits of achieving and maintaining sinus rhythm are discussed. For example, rhythm control has been associated with improvements in left ventricular function, AF symptoms, exercise tolerance, the ability to perform activities of daily living, and quality of life. More recently, dronedarone, a noniodinated benzofuran derivative approved for use in the treatment of AF, was shown to significantly improve clinical outcomes including cardiovascular hospitalizations and death from any cause in A Placebo‐Controlled, Double‐Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death From Any Cause in Patients With Atrial Fibrillation/Atrial Flutter (ATHENA). The review concludes with an examination of AF treatment options and expectations. Evidence suggests that the complete absence of AF recurrence is not always achievable; however, complete restoration of sinus rhythm may not be necessary for patients to achieve clinically meaningful benefits. Copyright © 2011 Wiley Periodicals, Inc.The editorial assistance provided for this manuscript was funded by Sanofi‐Aventis. The authors were fully responsible for all content and editorial decision, and received no financial support or other form of compensation related to the development of the paper. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Section: Treatment Expectations: Defining Treatment Goalsmentioning

confidence: 85%

Sinus Rhythm Restoration and Treatment Success: Insight From Recent Clinical Trials

Saliba

Wazni

2011

Clinical Cardiology

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“…52,53,54,55 These studies have demonstrated no difference in these endpoints. When interpreting the results of these studies, it is important to keep in mind the population of patients who were enrolled, the approach used for rhythm control, and the duration of follow-up.…”

Section: Section 2: Definitions Mechanisms and Rationale For Af Ablmentioning

confidence: 91%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,769

1,468

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“…[81][82][83][84] These studies highlighted the low clinical efficacy of current antiarrhythmic agents to maintain sinus rhythm. This probably contributes to the stroke risk associated with rhythm control, especially in a high-risk hypertensive population.…”

Section: Clinical Implicationmentioning

confidence: 99%

Hypertension and cardiac arrhythmias: a review of the epidemiology, pathophysiology and clinical implications

Yiu

Tse

2008

J Hum Hypertens

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Hypertension is commonly associated with cardiac arrhythmias in patients with and without concomitant cardiovascular disease. Experimental and epidemiological studies have demonstrated potential links between hypertension and atrial and ventricular arrhythmias, although the underlying pathophysiological mechanism remains unclear. Nonetheless, the importance of hypertension as a cause of atrial and ventricular arrhythmias is not well recognized. In particular, the occurrence of left ventricular hypertrophy is a strong predictor for the development of AF, ventricular ectopy and sudden cardiac death. Recent prospective clinical trials reveal that antihypertensive therapy may delay or prevent the occurrence of cardiac arrhythmias and sudden cardiac death in patients with hypertension. Although antihypertensive agents that block the renin-angiotensin-aldosterone system appear to protect against cardiac arrhythmias, this needs to be confirmed by current ongoing clinical trials.

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Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation

Cited by 852 publications

References 19 publications

Sinus Rhythm Restoration and Treatment Success: Insight From Recent Clinical Trials

Sinus Rhythm Restoration and Treatment Success: Insight From Recent Clinical Trials

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Hypertension and cardiac arrhythmias: a review of the epidemiology, pathophysiology and clinical implications

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