TY - JOUR
T1 - Early Rhythm Control Therapy in Patients With Atrial Fibrillation and Heart Failure
AU - Rillig, Andreas
AU - Magnussen, Christina
AU - Ozga, Ann-Kathrin
AU - Suling, Anna
AU - Brandes, Axel
AU - Breithardt, Gunter
AU - Camm, A. John
AU - Crijns, Harry J. G. M.
AU - Eckardt, Lars
AU - Elvan, Arif
AU - Goette, Andreas
AU - Gulizia, Michele
AU - Haegeli, Laurent
AU - Heidbuchel, Hein
AU - Kuck, Karl-Heinz
AU - Ng, Andre
AU - Szumowski, Lukasz
AU - van Gelder, Isabelle
AU - Wegscheider, Karl
AU - Kirchhof, Paulus
PY - 2021/9/14
Y1 - 2021/9/14
N2 - BACKGROUND: Even on optimal therapy, many patients with heart failure and atrial fibrillation experience cardiovascular complications. Additional treatments are needed to reduce these events, especially in patients with heart failure and preserved left ventricular ejection fraction.METHODS: This prespecified subanalysis of the randomized EAST-AFNET4 trial (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) assessed the effect of systematic, early rhythm control therapy (ERC; using antiarrhythmic drugs or catheter ablation) compared with usual care (allowing rhythm control therapy to improve symptoms) on the 2 primary outcomes of the trial and on selected secondary outcomes in patients with heart failure, defined as heart failure symptoms New York Heart Association II to III or left ventricular ejection fraction [LVEF]RESULTS: This analysis included 798 patients (300 [37.6%] female, median age 71.0 [64.0, 76.0] years, 785 with known LVEF). The majority of patients (n = 442) had heart failure and preserved LVEF (LVEF=50%; mean LVEF 61 +/- 6.3%), the others had heart failure with midrange ejection fraction (n=211; LVEF 40%-49%; mean LVEF 44 +/- 2.9%) or heart failure with reduced ejection fraction (n=132; LVEFCONCLUSIONS: Rhythm control therapy conveys clinical benefit when initiated within 1 year of diagnosing atrial fibrillation in patients with signs or symptoms of heart failure.
AB - BACKGROUND: Even on optimal therapy, many patients with heart failure and atrial fibrillation experience cardiovascular complications. Additional treatments are needed to reduce these events, especially in patients with heart failure and preserved left ventricular ejection fraction.METHODS: This prespecified subanalysis of the randomized EAST-AFNET4 trial (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) assessed the effect of systematic, early rhythm control therapy (ERC; using antiarrhythmic drugs or catheter ablation) compared with usual care (allowing rhythm control therapy to improve symptoms) on the 2 primary outcomes of the trial and on selected secondary outcomes in patients with heart failure, defined as heart failure symptoms New York Heart Association II to III or left ventricular ejection fraction [LVEF]RESULTS: This analysis included 798 patients (300 [37.6%] female, median age 71.0 [64.0, 76.0] years, 785 with known LVEF). The majority of patients (n = 442) had heart failure and preserved LVEF (LVEF=50%; mean LVEF 61 +/- 6.3%), the others had heart failure with midrange ejection fraction (n=211; LVEF 40%-49%; mean LVEF 44 +/- 2.9%) or heart failure with reduced ejection fraction (n=132; LVEFCONCLUSIONS: Rhythm control therapy conveys clinical benefit when initiated within 1 year of diagnosing atrial fibrillation in patients with signs or symptoms of heart failure.
KW - acute coronary syndrome
KW - anti-arrhythmia agents
KW - atrial fibrillation
KW - atrial fibrillation ablation
KW - controlled clinical trial
KW - death
KW - heart failure
KW - stroke
KW - CATHETER ABLATION
KW - DAPA-HF
U2 - 10.1161/CIRCULATIONAHA.121.056323
DO - 10.1161/CIRCULATIONAHA.121.056323
M3 - Article
SN - 0009-7322
VL - 144
SP - 845
EP - 858
JO - Circulation
JF - Circulation
IS - 11
ER -