Arrhythmias & electrophysiology

Rate control in atrial fibrillation, calcium channel blockers versus beta-blockers

HeartPublished Secondary analysis of the AFFIRM randomised trial

Authors' conclusion

In patients with non-permanent AF, calcium channel blockers instituted for rate control were associated with less bradycardia during sinus rhythm compared with beta-blockers.

Study context

Population
Patients with non-permanent atrial fibrillation (AF) in sinus rhythm at baseline on rate control drugs, with AF during follow-upof 4060 AFFIRM patients
Participants
474 patients
Comparison
Non-dihydropyridine calcium channel blockers vs beta-blockers for rate control
  • Calcium channel blockersn = 218
  • Beta-blockersn = 256reference
Primary endpoint
Heart rate during AF and during sinus rhythm

Primary result

As reported in the abstract

Resting heart rate <110 beats per min during AF

P = 1.00

Safety

Bradycardia during sinus rhythm · unadjusted

P < 0.001

OutcomeOR (95% CI)
Bradycardia during sinus rhythmAdjusted for patient characteristics0.41 (0.19–0.90)

Original publication

Rate control in atrial fibrillation, calcium channel blockers versus beta-blockers. Heart. Published 11 July 2023. doi:10.1136/heartjnl-2023-322635

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