PMID- 17631079
OWN - NLM
STAT- MEDLINE
DCOM- 20070905
LR  - 20070716
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 100
IP  - 2
DP  - 2007 Jul 15
TI  - Comparison of rate versus rhythm control for atrial fibrillation in patients with 
      left ventricular dysfunction (from the AFFIRM Study).
PG  - 247-52
AB  - Optimal treatment for patients with atrial fibrillation (AF) and left ventricular 
      (LV) dysfunction is not well defined. It is unclear if sinus rhythm is of greater 
      benefit in patients with significantly reduced ejection fraction (EF) than in 
      patients with normal or mildly depressed LV function. The Atrial Fibrillation 
      Follow-up Investigation of Rhythm Management (AFFIRM) study compared 2 treatment 
      strategies: "rhythm control," attempting to maintain sinus rhythm, principally 
      with antiarrhythmic drugs, and "rate control," allowing AF to persist or recur 
      while controlling the ventricular rate. We sought to determine if rhythm control 
      was superior to rate control for patients in the AFFIRM study with various 
      degrees of LV dysfunction. The present study analyzed outcome data of 3,032 
      subjects from the AFFIRM study with LV dysfunction by 3 EF strata: 40% to 49%, 
      30% to 39%, and <30%. The end points were mortality, hospitalization, and a 
      change in New York Heart Association (NYHA) class. Analyses were done by intent 
      to treat and by final rhythm status. In conclusion, there was no significant 
      improvement in mortality, hospitalization, and NYHA class with the strategy of 
      rhythm control in any of the 3 EF strata. When the data were analyzed by final 
      rhythm status, we again found no significant benefit to patients in the rhythm 
      control arm.
FAU - Freudenberger, Ronald S
AU  - Freudenberger RS
AD  - Department of Medicine, University of Medicine and Dentistry of New Jersey, 
      Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. 
      r.freudenberger@yahoo.com
FAU - Wilson, Alan C
AU  - Wilson AC
FAU - Kostis, John B
AU  - Kostis JB
CN  - AFFIRM Investigators and Committees
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20070604
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
MH  - Aged
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Atrial Fibrillation/physiopathology/*therapy
MH  - Female
MH  - Heart Rate/physiology
MH  - Humans
MH  - Male
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/*complications/physiopathology
EDAT- 2007/07/17 09:00
MHDA- 2007/09/06 09:00
CRDT- 2007/07/17 09:00
PHST- 2006/12/15 00:00 [received]
PHST- 2007/02/26 00:00 [revised]
PHST- 2007/02/26 00:00 [accepted]
PHST- 2007/07/17 09:00 [pubmed]
PHST- 2007/09/06 09:00 [medline]
PHST- 2007/07/17 09:00 [entrez]
AID - S0002-9149(07)00726-6 [pii]
AID - 10.1016/j.amjcard.2007.02.101 [doi]
PST - ppublish
SO  - Am J Cardiol. 2007 Jul 15;100(2):247-52. doi: 10.1016/j.amjcard.2007.02.101. Epub 
      2007 Jun 4.