6/28/23, 11:51 PM J-RHYTHM Pathway Feedback Search Clinical Topics Home Studies J RHYTHM J RHYTHM Disease Atrial fibrillation Trial question What is the role of rhythm control in patients with paroxysmal AF? Study design Multi-center Open label RCT Population Characteristics of study participants 31.0% female N = 823 69.0% male 823 patients (253 female, 570 male) Inclusion criteria: patients with paroxysmal AF Key exclusion criteria: initial AF episodes; contraindication for anticoagulation; AF occurring during the acute phase of myocardial infarction or cardiac surgery Interventions N=419 rhythm control (antiarrhythmic drugs selected according to the Japanese Guideline for AF Management) N=404 rate control (control of HR by -blockers, calcium-channel blockers, and digitalis) Primary outcome Composite of death, symptomatic cerebral infarction, systemic embolism, major bleeding, hospitalization for heart failure, or physical/psychological disability requiring alteration of treatment strategy 22.0 % 22 https://web.pathway.md/studies/recIOJmsujJod8Vsb 1/2 6/28/23, 11:51 PM J-RHYTHM Pathway 16.5 % 15.3 11.0 % Significant decrease NNT = 15 5.5 % 0.0 % Rhythm control Rate control Significant decrease in composite of death, symptomatic cerebral infarction, systemic embolism, major bleeding, hospitalization for HF, or physical/psychological disability requiring alteration of treatment strategy (15.3% vs. 22%; RR 0.7, 95% CI 0.15 to 1.25) Conclusion In patients with paroxysmal AF, rhythm control was superior to rate control with respect to the composite of death, symptomatic cerebral infarction, systemic embolism, major bleeding, hospitalization for HF, or physical/psychological disability requiring alteration of treatment strategy. Reference Satoshi Ogawa, Takeshi Yamashita, Tsutomu Yamazaki et al. Optimal treatment strategy for patients with paroxysmal atrial fibrillation: J-RHYTHM Study. Circ J. 2009 Feb;73(2):242-8. Open reference URL https://web.pathway.md/studies/recIOJmsujJod8Vsb 2/2