Rate Vs Rhythm Control
Acute restoration ie cardioversion and maintenance of sinus rhythm in patients with atrial fibrillation are referred to as rhythm control. Background randomized trials have not demonstrated significant differences in stroke heart failure or mortality between rhythm and rate control strategies.
Treatment Of Atrial Fibrillation Rate Vs Rhythm Control Upmc
A comparison of rate control and rhythm control in patients with atrial fibrillation.
Rate vs rhythm control. The comparative outcomes in contemporary clinical practice are not. Wyse dg waldo al dimarco jp et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation.
This course of treatment was my decision and my doctors went along with. Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. 59 p 0 06 particularly during the first year 46 vs.
Objectives the study sought to evaluate clinical outcomes in clinical practice with rhythm control versus rate control strategy for management of atrial fibrillation af. N engl j med 2002. Randomized trials of rate vs rhythm.
The decision to pursue rhythm control is based on symptoms the type of atrial. At 60 days a stable heart rhythm without atrial fibrillation had been achieved for the previous 30 days in 93 8 of the patients in the rate control group and in 97 9 of those in the rhythm. Van gelder ic hagens ve bosker ha et al.
Patients who present with symptomatic hypotension angina myocardial ischemia or heart failure should receive emergent therapy. Several trials addressing this issue were published in the last years 40 45 and two others are still ongoing 46 47 the pharmacological intervention in atrial fibrillation piaf piaf enrolled 252 patients with persistent atrial fibrillation duration up to 360 days in the first arm the strategy was to control heart rate using diltiazem while in the. Once better rate control is achieved and symptoms improve then a decision can be made to pursue chronic rate or rhythm control.
The proportion of patients who required hospitalization was higher in the rhythm control group than in the rate control group 64 vs. But one recent study published in the archives of internal medicine showed that in the longer. Generally rhythm control hasn t proved more effective than rate control for afib in clinical trials.
Rate control will slow down the heart rate to somewhere between 60 100 beats per minute without trying to control rhythm. Pharmacologic therapy is often very limited in patients presenting with hypotension. N engl j med 2002.
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