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As the number of us who have or will acquire atrial fibrillation (AF) grows, the decades-long debate about rhythm control versus rate control for AF treatment is increasingly important. Relatively strong evidence supports a rhythm-control strategy in patients with marked symptoms; however, no consensus exists on how to care for asymptomatic or mildly symptomatic individuals. In the AFFIRM trial, relatively asymptomatic patients fared similarly with rhythm- and rate-control strategies (JW Cardiol Jan 10 2003).
These investigators used administrative and drug claims data to study incidence of stroke or transient ischemic attack (TIA) in AF patients older than 65. Included were 16,325 Québec residents who filled a prescription for rhythm contro…