PMID- 30113568
OWN - NLM
STAT- MEDLINE
DCOM- 20190917
LR  - 20191015
IS  - 1897-9483 (Electronic)
IS  - 0032-3772 (Linking)
VI  - 128
IP  - 11
DP  - 2018 Nov 30
TI  - Functional status with rhythm- versus rate-control strategy for persistent atrial 
      fibrillation.
PG  - 658-666
LID - 10.20452/pamw.4316 [doi]
AB  - Introduction Recent studies have shown that rhythm control does not provide 
      additional benefit over rate control in terms of morbidity or mortality and is 
      less cost effective in patients with atrial fibrillation (AF). It remains to be 
      determined if any of the treatment strategies should be favored on the basis of 
      the quality of life (QoL) or functional capacity. Objectives This HOT CAFE 
      substudy was conducted to compare the functional status of patients with 
      persistent AF assigned either to rate or rhythm control strategy. Patients and 
      methods We enrolled 205 patients (mean [SD] age, 60.8 [11.2] years) with 
      persistent AF who were randomly assigned either to rate or rhythm control 
      strategies. The New York Heart Association (NYHA) functional classification, 
      intensity of arrhythmia‑related symptoms, exercise tolerance, and QoL were 
      analyzed. Results After a mean (SD) of 1.7 (0.4) years, the NYHA class and QoL 
      improved in both groups. Both strategies lead to improvement in AF‑related 
      symptoms. Treadmill test duration and maximal workload increased over time in 
      both groups. In terms of NYHA class improvement, rhythm control was superior to 
      rate control in patients with AF and hypertension (odds ratio [OR], 1.89; 95% CI, 
      0.98-3.65; P = 0.055) and in those with moderate HF (OR, 2.04; 95% CI, 1.03-4.06; 
      P = 0.04). When success was considered as left ventricular function improvement, 
      the rhythm‑control strategy also proved to be superior in patients with 
      hypertension (OR, 2.64; 95% CI, 1.21-5.74; P = 0.01) and those with NYHA class II 
      or III (OR, 4.27; 95% CI, 1.25-9.85; P <0.001). Conclusions Rate- and 
      rhythm‑control strategies improved functional status in patients with persistent 
      AF. However, rhythm control might be more appropriate for patients with AF and 
      hypertension and those with moderate HF.
FAU - Kosior, Dariusz A
AU  - Kosior DA
FAU - Szulc, Marcin
AU  - Szulc M
FAU - Rosiak, Marek
AU  - Rosiak M
FAU - Rabczenko, Daniel
AU  - Rabczenko D
FAU - Opolski, Grzegorz
AU  - Opolski G
FAU - For The Investigators Of The Hot Cafe Polish Study
AU  - For The Investigators Of The Hot Cafe Polish Study
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20180816
PL  - Poland
TA  - Pol Arch Intern Med
JT  - Polish archives of internal medicine
JID - 101700960
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
CIN - Pol Arch Intern Med. 2018 Nov 30;128(11):638-643. PMID: 30504753
MH  - Adult
MH  - Aged
MH  - Anti-Arrhythmia Agents/*therapeutic use
MH  - Atrial Fibrillation/*physiopathology/*therapy
MH  - Electric Countershock/*methods
MH  - Exercise Test
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Quality of Life
MH  - Treatment Outcome
MH  - Ventricular Function, Left
EDAT- 2018/08/17 06:00
MHDA- 2019/09/19 06:00
CRDT- 2018/08/17 06:00
PHST- 2018/08/17 06:00 [pubmed]
PHST- 2019/09/19 06:00 [medline]
PHST- 2018/08/17 06:00 [entrez]
AID - 10.20452/pamw.4316 [doi]
PST - ppublish
SO  - Pol Arch Intern Med. 2018 Nov 30;128(11):658-666. doi: 10.20452/pamw.4316. Epub 
      2018 Aug 16.