More Evidence for Early Rhythm Control in Patients with New Atrial Fibrillation

In 2020, the EAST-AFNET-4 trial called into question a rate-control strategy for higher-risk patients with minimally symptomatic or asymptomatic atrial fibrillation (AF); findings demonstrated that early rhythm control (within 12 months of AF diagnosis) improved cardiovascular outcomes (NEJM JW Gen Med Oct 1 2020 and N Engl J Med 2020; 383:1305). Now, investigators retrospectively assessed outcomes in >54,000 Korean patients who received early rhythm control (>98% via medications) or rate control within the first year after AF diagnoses. Follow up was ≈3 years, and propensity-weighted analysis helped control for differences between groups.

Among high-risk patients who met inclusion criteria for EAST-AFNET-4 (≈70% of the cohort; median age, 7…