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New trials in atrial fibrillation

S M Sopher1, A J Camm

  • 1Department of Cardiological Sciences, St. George's Hospital Medical School, London, United Kingdom.

Journal of Cardiovascular Electrophysiology
|September 4, 1998
PubMed
Summary

New clinical trials are evaluating atrial fibrillation (AF) management beyond blood clot prevention. Research is comparing rate control versus rhythm control strategies and assessing atrial pacing effectiveness for maintaining normal heart rhythm.

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Area of Science:

  • Cardiology
  • Clinical Trials
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) management is evolving beyond anticoagulation.
  • The fundamental debate in AF treatment is rate control versus rhythm control.

Purpose of the Study:

  • To evaluate the efficacy, cost, and safety of maintaining sinus rhythm in AF patients.
  • To assess the antiarrhythmic effects of atrial pacing compared to no pacing.

Main Methods:

  • Analysis of large-scale clinical trials including AFFIRM, PIAF, and RACE.
  • Evaluation of atrial pacing trials (AFT, SYNBIAPACE, DAPPAF) assessing dual-site pacing and algorithms.

Main Results:

  • Ongoing trials (AFFIRM, PIAF, RACE) will provide data on rhythm control strategies.
  • Atrial pacing shows promise for reducing AF episodes compared to ventricular pacing.

Conclusions:

  • The focus of AF research is shifting towards rhythm control and pacing strategies.
  • Further data from ongoing trials will clarify optimal AF management approaches.

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