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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Mending the rhythm does not improve prognosis in patients with persistent atrial fibrillation: a subanalysis of the
Michiel Rienstra1, Isabelle C Van Gelder, Vincent E Hagens
1Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
European Heart Journal
|November 9, 2005
Summary
Rhythm control did not improve outcomes for atrial fibrillation (AF) patients compared to rate control. Both strategies, when patients remained on warfarin, showed similar prognoses in the long term.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacology
Background:
- Atrial fibrillation (AF) management involves rate or rhythm control strategies.
- Oral anticoagulation is crucial for AF patients to prevent thrombo-embolic complications (TECs).
Purpose of the Study:
- To compare the long-term outcomes of AF patients managed with effective rhythm control versus rate control.
- To evaluate the impact of maintaining sinus rhythm on patient prognosis.
Main Methods:
- Analysis of data from the RACE study, comparing patients randomized to rhythm control with those in rate control.
- Patients were continuously treated with oral anticoagulation (warfarin).
- Primary endpoint included cardiovascular mortality, heart failure, TECs, bleeding, adverse drug effects, and pacemaker implants.
Main Results:
- The primary endpoint occurred in 22.4% of the rhythm-control group versus 15.2% in the rate-control group.
- No significant difference in prognosis was observed between groups when patients remained on warfarin.
- Coronary artery disease, heart failure, and digitalis were independent risk indicators for adverse outcomes.
Conclusions:
- Maintaining sinus rhythm through rhythm control did not confer a superior prognosis compared to rate control in AF patients on warfarin.
- The study suggests that for patients remaining on anticoagulation, the long-term prognosis is similar regardless of rate or rhythm control strategy.
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