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      Comparative occurrence of ischemic stroke with the rhythm versus rate control strategy in a national prospective cohort of atrial fibrillation = Comparative occurrence of ischemic stroke with the rhythm versus rate control strategy in a national prospective cohort of atrial fibrillation

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      https://www.riss.kr/link?id=A107185126

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      다국어 초록 (Multilingual Abstract)

      Background/Aims: Comparative occurrence of ischemic stroke for rhythm versus rate control strategy in patients with non-valvular atrial fibrillation (NVAF) is still inconclusive. The purpose of this study was to investigate whether the rhythm control ...

      Background/Aims: Comparative occurrence of ischemic stroke for rhythm versus rate control strategy in patients with non-valvular atrial fibrillation (NVAF) is still inconclusive. The purpose of this study was to investigate whether the rhythm control strategy is associated with a lower risk of ischemic stroke compared to the rate control strategy in NVAF patients.
      Methods: The CODE-AF registry prospectively enrolled 6,280 consecutive patients who were treated for NVAF at 10 tertiary referral centers in South Korea. Of these, 2,513 NVAF patients (age, 67 ± 10 years; male, 61.8%) were clinically followed up for over 1-year and divided into rate and rhythm control groups.
      Results: Those treated with the rhythm control strategy were younger and had less proportions of underlying disease compared to those treated with the rate control strategy. After the propensity matching analysis, those treated with the rhythm control strategy had similar baseline characteristics including the CHA<sub>2</sub>DS<sub>2</sub>-VASC score compared to those treated with the rate control strategy. The rate of oral anticoagulation, all bleeding, and hospitalization were also similarly between the two groups. The incidence rate of ischemic stroke in the rhythm control group was significantly lower than in the rate control group (0.7 vs. 6.9 per 1,000 person-years, p = 0.011).
      Conclusions: The rhythm control strategy demonstrated a beneficial effect to lower the risk of ischemic stroke during a 1-year follow-up compared to the rate control strategy.

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      참고문헌 (Reference)

      1 Rolf S, "What can rhythm control therapy contribute to prognosis in atrial fibrillation?" 101 : 842-846, 2015

      2 Sethi NJ, "The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter : a systematic review with meta-analysis and Trial Sequential Analysis" 12 : e0186856-, 2017

      3 Sherman DG, "Stroke prevention in atrial fibrillation : pharmacological rate versus rhythm control" 38 (38): 615-617, 2007

      4 Freedman B, "Stroke prevention in atrial fibrillation" 388 : 806-817, 2016

      5 Tsadok MA, "Rhythm versus rate control therapy and subsequent stroke or transient ischemic attack in patients with atrial fibrillation" 126 : 2680-2687, 2012

      6 Hohnloser SH, "Rhythm or rate control in atrial fibrillation : pharmacological Intervention in Atrial Fibrillation(PIAF) : a randomised trial" 356 : 1789-1794, 2000

      7 Noheria A, "Rhythm control versus rate control and clinical outcomes in patients with atrial fibrillation : results from the ORBIT-AF registry" 2 : 221-229, 2016

      8 Camm AJ, "Real-life observations of clinical outcomes with rhythm-and rate-control therapies for atrial fibrillation RECORDAF(Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)" 58 : 493-501, 2011

      9 Al-Khatib SM, "Rate-and rhythm-control therapies in patients with atrial fibrillation : a systematic review" 160 : 760-773, 2014

      10 Steinberg BA, "Rate versus rhythm control for management of atrial fibrillation in clinical practice : results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation(ORBIT-AF)registry" 165 : 622-629, 2013

      1 Rolf S, "What can rhythm control therapy contribute to prognosis in atrial fibrillation?" 101 : 842-846, 2015

      2 Sethi NJ, "The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter : a systematic review with meta-analysis and Trial Sequential Analysis" 12 : e0186856-, 2017

      3 Sherman DG, "Stroke prevention in atrial fibrillation : pharmacological rate versus rhythm control" 38 (38): 615-617, 2007

      4 Freedman B, "Stroke prevention in atrial fibrillation" 388 : 806-817, 2016

      5 Tsadok MA, "Rhythm versus rate control therapy and subsequent stroke or transient ischemic attack in patients with atrial fibrillation" 126 : 2680-2687, 2012

      6 Hohnloser SH, "Rhythm or rate control in atrial fibrillation : pharmacological Intervention in Atrial Fibrillation(PIAF) : a randomised trial" 356 : 1789-1794, 2000

      7 Noheria A, "Rhythm control versus rate control and clinical outcomes in patients with atrial fibrillation : results from the ORBIT-AF registry" 2 : 221-229, 2016

      8 Camm AJ, "Real-life observations of clinical outcomes with rhythm-and rate-control therapies for atrial fibrillation RECORDAF(Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)" 58 : 493-501, 2011

      9 Al-Khatib SM, "Rate-and rhythm-control therapies in patients with atrial fibrillation : a systematic review" 160 : 760-773, 2014

      10 Steinberg BA, "Rate versus rhythm control for management of atrial fibrillation in clinical practice : results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation(ORBIT-AF)registry" 165 : 622-629, 2013

      11 Gillinov AM, "Rate control versus rhythm control for atrial fibrillation after cardiac surgery" 374 : 1911-1921, 2016

      12 Hagens VE, "Rate control is more cost-effective than rhythm control for patients with persistent atrial fibrillation : results from the RAte Control versus Electrical cardioversion(RACE)study" 25 : 1542-1549, 2004

      13 Chatterjee S, "Pharmacologic rate versus rhythm-control strategies in atrial fibrillation : an updated comprehensive review and meta-analysis" 36 : 122-133, 2013

      14 Bunch TJ, "Patients treated with catheter ablation for atrial fibrillation have longterm rates of death, stroke, and dementia similar to patients without atrial fibrillation" 22 : 839-845, 2011

      15 Suzuki S, "Incidence of ischemic stroke in Japanese patients with atrial fibrillation not receiving anticoagulation therapy : pooled analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry" 79 : 432-438, 2015

      16 Calkins H, "HRS/EHRA/ECAS expert Consensus Statement on catheter and surgical ablation of atrial fibrillation : recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society(HRS)Task Force on catheter and surgical ablation of atrial fibrillation" 4 : 816-861, 2007

      17 Hatano S, "Experience from a multicentre stroke register : a preliminary report" 54 : 541-553, 1976

      18 Stevens PE, "Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline" 158 : 825-830, 2013

      19 Meinertz T, "Efficacy and safety of propafenone sustained release in the prophylaxis of symptomatic paroxysmal atrial fibrillation(The European Rythmol/Rytmonorm Atrial Fibrillation Trial [ERAFT]Study)" 90 : 1300-1306, 2002

      20 Schulman S, "Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients" 3 : 692-694, 2005

      21 Kaatz S, "Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH" 13 : 2119-2126, 2015

      22 Ruff CT, "Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation : a meta-analysis of randomised trials" 383 : 955-962, 2014

      23 Ionescu-Ittu R, "Comparative effectiveness of rhythm control vs rate control drug treatment effect on mortality in patients with atrial fibrillation" 172 : 997-1004, 2012

      24 Packer DL, "Catheter ablation versus antiarrhythmic drug therapy for atrial fibrillation(CABANA)trial : study rationale and design" 199 : 192-199, 2018

      25 Saliba W, "Catheter ablation of atrial fibrillation is associated with reduced risk of stroke and mortality : a propensity score-matched analysis" 14 : 635-642, 2017

      26 Scheinman MM, "Atrial fibrillation therapy : rate versus rhythm control" 26 : 1175-1177, 2003

      27 Bunch TJ, "Atrial fibrillation ablation patients have long-term stroke rates similar to patients without atrial fibrillation regardless of CHADS2score" 10 : 1272-1277, 2013

      28 Keun-Hwa Jung, "Antithrombotic Management of Patients with Nonvalvular Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack: Executive Summary of the Korean Clinical Practice Guidelines for Stroke" 대한뇌졸중학회 17 (17): 210-215, 2015

      29 Austin PC, "An introduction to propensity score methods for reducing the effects of confounding in observational studies" 46 : 399-424, 2011

      30 Wyse DG, "A comparison of rate control and rhythm control in patients with atrial fibrillation" 347 : 1825-1833, 2002

      31 김형수, "A Prospective Survey of Atrial Fibrillation Management for Real-world Guideline Adherence: COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) Registry" 대한심장학회 47 (47): 877-887, 2017

      32 Kirchhof P, "2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS" 37 : 2893-2962, 2016

      33 January CT, "2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation : a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society" 130 : e199-e267, 2014

      34 January CT, "2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation : a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society" 64 : e1-e76, 2014

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