PMID- 15976795
OWN - NLM
STAT- MEDLINE
DCOM- 20051128
LR  - 20231024
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 149
IP  - 6
DP  - 2005 Jun
TI  - Rate control versus rhythm control for patients with persistent atrial 
      fibrillation with mild to moderate heart failure: results from the RAte Control 
      versus Electrical cardioversion (RACE) study.
PG  - 1106-11
AB  - BACKGROUND: This study was conducted to compare rate- and rhythm-control therapy 
      in patients with persistent atrial fibrillation (AF) and mild to moderate chronic 
      heart failure (CHF). Rate control is not inferior to rhythm control in preventing 
      mortality and morbidity in patients with AF. In CHF, this issue is still 
      unsettled. METHODS: In this predefined analysis of the RACE study, a total of 261 
      patients were in New York Heart Association (NYHA) classes II and III at 
      baseline. These patients were analyzed. The primary end point was a composite of 
      cardiovascular mortality, hospitalization for CHF, thromboembolic complications, 
      bleeding, pacemaker implantation, and life-threatening drug side effects. 
      Furthermore, quality of life was compared. RESULTS: After 2.3 +/- 0.6 years, the 
      primary end point occurred in 29 (22.3%) of the 130 rate-control patients and in 
      32 (24.4%) of the 131 rhythm-control patients. More cardiovascular deaths, 
      hospitalization for CHF, and bleeding occurred under rate control. Thromboembolic 
      complications, drug side effects, and pacemaker implantation were more frequent 
      under rhythm control. Quality of life did not differ between strategies. In 
      patients successfully treated with rhythm control, the prevalence of end points 
      was not different from those who were in AF at study end. However, the type of 
      end point was different: mortality, bleeding, hospitalization for heart failure, 
      and pacemaker implantation occurred less frequently. CONCLUSIONS: In patients 
      with mild to moderate CHF, rate control is not inferior to rhythm control. 
      However, if sinus rhythm can be maintained, outcome may be improved. A 
      prospective randomized trial is necessary to confirm these results.
FAU - Hagens, Vincent E
AU  - Hagens VE
AD  - Department of Cardiology, University Medical Center Groningen, Groningen, The 
      Netherlands.
FAU - Crijns, Harry J G M
AU  - Crijns HJ
FAU - Van Veldhuisen, Dirk J
AU  - Van Veldhuisen DJ
FAU - Van Den Berg, Maarten P
AU  - Van Den Berg MP
FAU - Rienstra, Michiel
AU  - Rienstra M
FAU - Ranchor, Adelita V
AU  - Ranchor AV
FAU - Bosker, Hans A
AU  - Bosker HA
FAU - Kamp, Otto
AU  - Kamp O
FAU - Tijssen, Jan G P
AU  - Tijssen JG
FAU - Veeger, Nic J G M
AU  - Veeger NJ
FAU - Van Gelder, Isabelle C
AU  - Van Gelder IC
CN  - RAte Control versus Electrical cardioversion for persistent atrial fibrillation 
      study group
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
CIN - Am Heart J. 2005 Jun;149(6):957-9. PMID: 15976773
MH  - Aged
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Atrial Fibrillation/*complications/physiopathology/*therapy
MH  - *Electric Countershock
MH  - Female
MH  - Heart Failure/*complications/physiopathology/*therapy
MH  - *Heart Rate
MH  - Humans
MH  - Male
MH  - Severity of Illness Index
EDAT- 2005/06/25 09:00
MHDA- 2005/12/13 09:00
CRDT- 2005/06/25 09:00
PHST- 2005/06/25 09:00 [pubmed]
PHST- 2005/12/13 09:00 [medline]
PHST- 2005/06/25 09:00 [entrez]
AID - S0002870305000463 [pii]
AID - 10.1016/j.ahj.2004.11.030 [doi]
PST - ppublish
SO  - Am Heart J. 2005 Jun;149(6):1106-11. doi: 10.1016/j.ahj.2004.11.030.