PURPOSE OF REVIEW: The present review will examine the prognostic importance of atrial fibrillation and heart failure, explore the different therapeutic options for treating atrial fibrillation and present the results of the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. RECENT FINDINGS: The Atrial Fibrillation and Congestive Heart Failure trial was a randomized trial involving patients with both atrial fibrillation and heart failure. The trial was designed to compare the maintenance of sinus rhythm with the control of ventricular rate in patients with left ventricular dysfunction, heart failure and a history of atrial fibrillation. There was no significant difference in the rate of death from cardiovascular causes in the rhythm-control group as compared with the rate-control strategy. In addition, there was no significant difference in any of the secondary outcomes including death from any cause, worsening heart failure or stroke. The rate-control strategy eliminated the need for repeated cardioversion and reduced rates of hospitalization. SUMMARY: The results of the Atrial Fibrillation and Congestive Heart Failure trial indicate that a routine strategy of rhythm control does not reduce rate of death and suggest that rate control should be considered a primary approach for patients with atrial fibrillation and heart failure.
RCT Entities:
PURPOSE OF REVIEW: The present review will examine the prognostic importance of atrial fibrillation and heart failure, explore the different therapeutic options for treating atrial fibrillation and present the results of the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. RECENT FINDINGS: The Atrial Fibrillation and Congestive Heart Failure trial was a randomized trial involving patients with both atrial fibrillation and heart failure. The trial was designed to compare the maintenance of sinus rhythm with the control of ventricular rate in patients with left ventricular dysfunction, heart failure and a history of atrial fibrillation. There was no significant difference in the rate of death from cardiovascular causes in the rhythm-control group as compared with the rate-control strategy. In addition, there was no significant difference in any of the secondary outcomes including death from any cause, worsening heart failure or stroke. The rate-control strategy eliminated the need for repeated cardioversion and reduced rates of hospitalization. SUMMARY: The results of the Atrial Fibrillation and Congestive Heart Failure trial indicate that a routine strategy of rhythm control does not reduce rate of death and suggest that rate control should be considered a primary approach for patients with atrial fibrillation and heart failure.
Authors: Alanna M Chamberlain; Margaret M Redfield; Alvaro Alonso; Susan A Weston; Véronique L Roger Journal: Circ Heart Fail Date: 2011-09-15 Impact factor: 8.790
Authors: Duanping Liao; Michele L Shaffer; Fan He; Sol Rodriguez-Colon; Rongling Wu; Eric A Whitsel; Edward O Bixler; Wayne E Cascio Journal: J Toxicol Environ Health A Date: 2011
Authors: Mark S Link; Heike Luttmann-Gibson; Joel Schwartz; Murray A Mittleman; Benjamin Wessler; Diane R Gold; Douglas W Dockery; Francine Laden Journal: J Am Coll Cardiol Date: 2013-06-13 Impact factor: 24.094
Authors: Anne M Butler; Xiaoyan Yin; Daniel S Evans; Michael A Nalls; Erin N Smith; Toshiko Tanaka; Guo Li; Sarah G Buxbaum; Eric A Whitsel; Alvaro Alonso; Dan E Arking; Emelia J Benjamin; Gerald S Berenson; Josh C Bis; Wei Chen; Rajat Deo; Patrick T Ellinor; Susan R Heckbert; Gerardo Heiss; Wen-Chi Hsueh; Brendan J Keating; Kathleen F Kerr; Yun Li; Marian C Limacher; Yongmei Liu; Steven A Lubitz; Kristin D Marciante; Reena Mehra; Yan A Meng; Anne B Newman; Christopher Newton-Cheh; Kari E North; Cameron D Palmer; Bruce M Psaty; P Miguel Quibrera; Susan Redline; Alex P Reiner; Jerome I Rotter; Renate B Schnabel; Nicholas J Schork; Andrew B Singleton; J Gustav Smith; Elsayed Z Soliman; Sathanur R Srinivasan; Zhu-ming Zhang; Alan B Zonderman; Luigi Ferrucci; Sarah S Murray; Michele K Evans; Nona Sotoodehnia; Jared W Magnani; Christy L Avery Journal: Circ Cardiovasc Genet Date: 2012-11-08