Arrhythmias & electrophysiology
Rhythm vs Rate Control Strategy for Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials
Pooled result · CV deathResult — go to the resultHazard ratio 0.78 95% CI 0.62–0.96Authors' conclusion
In patients with AF, a contemporary rhythm control strategy leads to reduced CV mortality, HF events, and stroke compared with a rate control strategy.
Study context
- Population
- Patients with nonvalvular atrial fibrillation (AF)
- Participants
- 17,536 patients18 studies
- Comparison
- Rhythm control vs rate control
- Outcome
- Cardiovascular (CV) death
Methodological detailscumulative meta-analysis, meta-regression
- Cumulative meta-analysis
- Meta-regression
Pooled result
As reported in the abstract
Hazard ratio
0.78
95% CI 0.62–0.96
Rhythm controlvs Rate control
HR 0.78 (95% CI 0.62–0.96)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| Stroke | 0.801 (0.643–0.998) | |
| Hospitalisation for HF | 0.80 (0.69–0.94) | |
| All-cause death | 0.86 (0.73–1.02) | |
| 0.512Hazard ratio (log scale) |
Temporal trends and ablation use (cumulative meta-analysis, meta-regression)
- Benefit driven by contemporary studies; more ablation use in rhythm control associated with improved outcomes, except stroke
Original publication
Rhythm vs Rate Control Strategy for Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials. JACC Clin Electrophysiol. Published 8 May 2024. doi:10.
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