Risks and benefits of rate control versus maintenance of sinus rhythm

摘要: There are 2 fundamental approaches to managing patients with recurrent atrial fibrillation (AF): restore and maintain sinus rhythm cardioversion and/or antiarrhythmic drugs, or control the ventricular rate only. Over past few years, there have been several important prospective clinical trials comparing in AF. The Pharmacological Intervention Atrial Fibrillation (PIAF) trial was first randomized study test hypothesis of equivalency between management strategies for demonstrated that not inferior respect symptoms, quality life, number hospitalizations persistent Strategies Treatment (STAF) a pilot enrolled approximately 200 AF who were either maintenance rhythm. results showed over 1-year period little difference outcome terms morbidity symptoms. In Follow-up Investigation Rhythm Management (AFFIRM) trial, risk factors stroke control, both groups receiving anticoagulation warfarin. no composite end point death, disabling anoxic encephalopathy, major bleeding, cardiac arrest arms. addition, differences noted functional status life. Rate Control Versus Electrical Cardioversion (RACE) also reached similar conclusion. Thus, is an acceptable primary strategy