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Baseline characteristics of patients with atrial fibrillation: the AFFIRM Study
Insights
The AFFIRM Study compared rate control versus rhythm control for atrial fibrillation in over 4000 elderly patients. Baseline characteristics show a high-risk population representative of those seen in clinical practice.
Area of Science:
- Cardiology
- Clinical Trials
- Electrophysiology
Background:
- Atrial fibrillation management involves two strategies: ventricular rate control or rhythm control.
- Anticoagulation is standard for most patients with atrial fibrillation.
Purpose of the Study:
- To compare the efficacy and safety of ventricular rate control versus rhythm control strategies in patients with atrial fibrillation.
- To report the baseline characteristics of patients enrolled in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Study.
Main Methods:
- The AFFIRM Study was a large, randomized clinical trial.
- Over 4000 patients were enrolled across more than 200 North American sites.
Main Results:
- The study enrolled 4060 patients, with an average age of 70 years.
- Common comorbidities included hypertension (71%) and coronary artery disease (38%).
- A significant proportion of patients had normal left ventricular function (68%) but abnormal left atrial size (33%).
Conclusions:
- The AFFIRM Study enrolled a high-risk population of predominantly elderly patients with atrial fibrillation.
- The baseline characteristics suggest the trial results will be highly relevant to real-world patient care.
Background:
Although anticoagulation therapy is accepted for most patients with atrial fibrillation, 2 different strategies exist for management of the cardiac rhythm: atrial fibrillation is allowed to persist while the ventricular rate is controlled; and atrial fibrillation is converted, and an attempt is made to maintain sinus rhythm.
Methods:
The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Study was a randomized clinical trial that compared these 2 strategies. We report the baseline characteristics of the patients enrolled in the AFFIRM Study.
Results:
More than 7400 patients at more than 200 North American hospitals and clinics qualified for enrollment in the AFFIRM Study. A total of 4060 patients were enrolled in the AFFIRM Study. The average age of patients enrolled was 70 years, with 39% female and 89% white. Hypertension was present in 71%. Coronary artery disease was present in 38%. Echocardiography was performed in 3311 patients, and results showed normal ventricular function in 68% and normal left atrial size in 33%. Most patients with recurrent episodes had symptoms with atrial fibrillation. Approximately one third of patients were enrolled with a first episode of atrial fibrillation.
Conclusion:
The AFFIRM Study enrolled 4060 predominantly elderly patients with atrial fibrillation to compare ventricular rate control with rhythm control. The patients in the AFFIRM Study were representative of patients at high risk for complications from atrial fibrillation, which indicates that the results of this large clinical trial will be relevant to patient care.