Arrhythmias & electrophysiology

Early Rhythm Control in Patients With Incident Atrial Fibrillation Who Had a Prior Stroke

JACC Clin ElectrophysiolPublished Retrospective cohort study

Main finding · Recurrent strokeResult — go to the resultWeighted hazard ratio 0.720 95% CI 0.666–0.779

Authors' conclusion

Early rhythm control within 1 year after AF diagnosis might be beneficial to prevent recurrent stroke in patients with incident AF and a history of stroke.

Study context

Population
Patients newly diagnosed with atrial fibrillation (AF) and a history of prior stroke, Korean nationwide claims database; all prescribed OAC
Participants
53,509 patients
Exposure
Early rhythm control vs usual care
  • Early rhythm controln = 12,455
  • Usual caren = 41,054reference
Outcome
Incident (recurrent) stroke
Follow-up
Median 2.6 years
Methodological detailspropensity score weighting, nationwide claims database
  • Propensity score weighting
  • Nationwide claims database

Main finding

Recurrent stroke · median 2.6 years

Weighted hazard ratio

0.720

95% CI 0.666–0.779

P < 0.001

Early rhythm controlvs Usual care
weighted HR 0.720 (95% CI 0.666–0.779); P < 0.001

As reported in the abstract

Incident stroke, overall (4,382 patients)
2.6 per 100 person-years

Observational data: associations, not effects.

Original publication

Early Rhythm Control in Patients With Incident Atrial Fibrillation Who Had a Prior Stroke. JACC Clin Electrophysiol. Published 22 February 2023. doi:10.1016/j.jacep.2022.11.021

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