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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Rate versus rhythm control in atrial fibrillation

Korin K Anthony1, Vincent F Mauro

  • 1University of Toledo, Toledo, OH, USA. korinrph@hotmail.com

The Annals of Pharmacotherapy
|March 25, 2004
PubMed

Insights

Rate control is a viable initial treatment for persistent atrial fibrillation (AF), showing no inferiority to rhythm control regarding mortality. This approach also reduces hospitalizations and adverse effects, making it a reasonable first-line strategy, particularly for elderly patients.

Area of Science:

  • Cardiology
  • Clinical Trials
  • Pharmacology

Background:

  • Persistent atrial fibrillation (AF) management strategies include rate and rhythm control.
  • Recent trials have compared the efficacy and safety of these two approaches.

Purpose of the Study:

  • To evaluate if rate control is a viable initial treatment for persistent AF.
  • To compare rate control versus rhythm control in managing AF based on recent trial data.

Main Methods:

  • Biomedical literature search of MEDLINE and the Iowa database (1966-2003).
  • Inclusion of relevant articles identified from the literature search.
  • Review and synthesis of data from selected studies.

Main Results:

  • Rate control demonstrated non-inferiority to rhythm control concerning mortality in persistent AF.
  • Rate control was associated with reduced hospitalizations and fewer proarrhythmic events.
  • No significant differences were found between rate and rhythm control for thromboembolism and stroke incidence.

Conclusions:

  • Rate control is a reasonable first-line strategy for persistent AF, especially in asymptomatic or mildly symptomatic elderly patients.
  • Rhythm control is linked to higher hospitalization rates and antiarrhythmic drug adverse effects.
  • Further research is necessary to define the role of rate control in younger AF patients.
Abstract

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