Document Detail


Mending the rhythm does not improve prognosis in patients with persistent atrial fibrillation: a subanalysis of the RACE study.
MedLine Citation:
PMID:  16275661     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To compare outcome of AF patients with effective rhythm control with patients treated with rate control. METHODS AND RESULTS: Out of the 266 AF patients randomized to rhythm control in the RACE study, 49 patients turned to long-term sinus rhythm and were continuously treated with oral anticoagulation. The incidence of the primary endpoint in these patients was compared to that in 178 patients out of the initial 256 rate-control patients of RACE who were in AF and using oral anticoagulation continuously. Baseline characteristics of both groups were not different. After a mean follow-up of 2.3+/-0.6 years, the primary endpoint (a composite of cardiovascular mortality, heart failure, thrombo-embolic complications (TECs), bleeding, serious adverse effects of antiarrhythmic drugs and pacemaker implants) was 22.4% in the rhythm-control group vs. 15.2% in the rate-control group. Multivariable regression analysis indicated coronary artery disease, heart failure, and digitalis as independent risk indicators of cardiovascular morbidity and mortality. Chronic sinus rhythm did not matter. CONCLUSION: Among patients who remained on warfarin, those who mostly were maintained in sinus rhythm under a rhythm-control strategy did not have a superior prognosis compared to those who remained in AF under a rate-control strategy.
Authors:
Michiel Rienstra; Isabelle C Van Gelder; Vincent E Hagens; Nic J G M Veeger; Dirk J Van Veldhuisen; Harry J G M Crijns
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-11-07
Journal Detail:
Title:  European heart journal     Volume:  27     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-13     Completed Date:  2006-07-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  357-64     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / therapeutic use*
Anticoagulants / therapeutic use
Atrial Fibrillation / mortality,  therapy*
Chronic Disease
Combined Modality Therapy
Disease-Free Survival
Electric Countershock / methods*
Female
Humans
Male
Prognosis
Quality of Life
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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