6/28/23, 12:04 AM AF-CHF Pathway Feedback Search Clinical Topics Home Studies AF CHF AF CHF Disease Disease Atrial fibrillation Heart failure Trial question Is a rhythm-control strategy superior to a rate-control strategy in patients with AF and congestive HF? Study design Multi-center Open label RCT Population Characteristics of study participants 18.0% female N = 1376 82.0% male 1376 patients (254 female, 1122 male) Inclusion criteria: patients with an LVEF 35%, symptoms of congestive HF, and a history of AF Key exclusion criteria: persistent AF for > 12 months, a reversible cause of AF or HF, decompensated HF within 48 hours before intended randomization, the use of antiarrhythmic drugs for other arrhythmias, second-degree or third-degree AV block, a history of the long-QT syndrome, previous ablation of an atrioventricular node, anticipated cardiac transplantation within 6 months, renal failure requiring dialysis Interventions N=682 rhythm control (maintenance of sinus rhythm) N=694 rate control (control of the ventricular rate) https://web.pathway.md/studies/recgMNqTR7nu14H8o 1/2 6/28/23, 12:04 AM AF-CHF Pathway Primary outcome Death from cardiovascular causes 27.0 % 27 25 20.3 % 13.5 % 6.8 % No significant difference 0.0 % Rhythm control Rate control No significant difference in death from cardiovascular causes (27% vs. 25%; HR 1.06, 95% CI 0.86 to 1.3) Secondary outcomes No significant difference in death from any cause (32% vs. 33%; RR 0.97, 95% CI -3.45 to 5.39) Conclusion In patients with an LVEF 35%, symptoms of congestive HF, and a history of AF, rhythm control was not superior to rate control with respect to death from cardiovascular causes. Reference Roy D, Talajic M, Nattel S et al. Rhythm control versus rate control for atrial fibrillation and heart failure. N Engl J Med. 2008 Jun 19;358(25):2667-77. Open reference URL https://web.pathway.md/studies/recgMNqTR7nu14H8o 2/2