Atrial fibrillation (AF) is one of the most common cardiovascular diseases characterized by the irregular and rapid heart rate as a result of chaotic electric signals. Despite various developments in the field of cardiology, patients with AF remain at a higher risk of mortality, morbidity, and other cardiovascular complications. This study aims to evaluate the efficacy of early rhythm-control therapy for AF.
This open, parallel-group, investigator-initiated, blinded-outcome-assessment trial included a total of 2,789 patients with early AF. The patients were randomly assigned to receive either early rhythm control (or usual care. The primary outcome of the study was a composite of severe cardiovascular outcomes, such as cardiovascular death, stroke, or hospitalization due to heart failure.
During a median follow-up of 5.1 years, the primary outcome occurred in 249 patients in the rhythm-control group (3.9 per 100 person-years) and 316 patients (5.0 per 100 person-years) in the usual care group. However, the number of nights spent in hospital and the percentage of patients with a primary safety outcome did not differ in the two groups. The rate of serious adverse outcomes was higher (4.9%) in the rhythm-control group compared with the usual care group (1.4%).
The research concluded that in patients with AF, early rhythm-control therapy was associated with a lower risk of adverse cardiovascular outcomes but a slightly higher risk of treatment-related adverse events.
Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2019422
