REBEL EM - November 23, 2020 - By Benjamin M. Gerretsen
Paper: Kirchhof et al. Early Rhythm-Control Therapy in Patients with Atrial Fibrillation. NEJM 2020. PMID 32865375"Clinical Question: Does early rhythm-control or rate-control therapy reduce the risk of cardiovascular complications in patients with atrial fibrillation?
Author Conclusion: “Early rhythm-control therapy was associated with a lower risk of adverse cardiovascular outcomes than usual care among patients with early atrial fibrillation and cardiovascular conditions.”
Clinical Take Home Point / What Do I Tell My Patient: An association was found between early rhythm-control and reduction of AF-related adverse clinical outcomes in patients with recent atrial fibrillation diagnosis and cardiovascular disease, without affecting the number of nights spent in hospital. While early rhythm-control was associated with more adverse events, the incidence of the overall safety outcome events was similar in the two groups. The result of this trial support the use of rhythm control to reduce atrial fibrillation–related adverse clinical outcomes when applied early in the treatment of patients with atrial fibrillation."
Author Conclusion: “Early rhythm-control therapy was associated with a lower risk of adverse cardiovascular outcomes than usual care among patients with early atrial fibrillation and cardiovascular conditions.”
Clinical Take Home Point / What Do I Tell My Patient: An association was found between early rhythm-control and reduction of AF-related adverse clinical outcomes in patients with recent atrial fibrillation diagnosis and cardiovascular disease, without affecting the number of nights spent in hospital. While early rhythm-control was associated with more adverse events, the incidence of the overall safety outcome events was similar in the two groups. The result of this trial support the use of rhythm control to reduce atrial fibrillation–related adverse clinical outcomes when applied early in the treatment of patients with atrial fibrillation."