Benefit of Rhythm Control Over Rate Control in Atrial Fibrillation: Does Timing Matter?

A retrospective cohort study demonstrates lower risk for adverse outcomes with a rhythm-control strategy, but only when initiated within a year of diagnosis.

The EAST-AFNET 4 randomized trial (NCT01288352) showed a benefit of a rhythm-control strategy compared with a rate-control strategy in patients with new-onset (<1 year) atrial fibrillation (AF; NEJM JW Cardiol Oct 2020 and N Engl J Med 2020; 383:1305 and 1383). Now, using Korean national health claims data, investigators have analyzed whether the comparative benefit of rhythm versus rate control varies by timing of treatment.

The retrospective cohort study included approximately 16,300 adults undergoing early treatment of AF (i.e., within the first year of diagnosis) and 6300 undergoing late treatment (>1 year after diagnosis) with rhythm control or rate control. Median follow-up was 2 years. Risk for a composite outcome of adverse cardiovas…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Benefit of Rhythm Control Over Rate Control in Atrial Fibrillation: Does Timing Matter?

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Reviewing Author