Clinical factors associated with abandonment of a rate-control or a rhythm-control strategy for the management of atrial fibrillation in the AFFIRM study

The objective of the current study was to determine the clinical factors that were associated with abandonment of a rate-control or a rhythm-control strategy in patients with atrial fibrillation (AF). Although the AFFIRM Study demonstrated that outcomes are similar with a primary strategy of rate-co...

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Bibliographic Details
Published in:The American heart journal 2005-02, Vol.149 (2), p.304-308
Main Authors: Curtis, Anne B., Seals, A. Allen, Safford, Robert E., Slater, William, Tullo, Nicholas G., Vidaillet, Humberto, Wilber, David J., Slee, April
Format: Article
Language:English
Subjects:
Age Factors
Aged
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - mortality
Atrial Fibrillation - physiopathology
Atrial Fibrillation - therapy
Biological and medical sciences
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiology. Vascular system
Cardiovascular disease
Drug therapy
Electric Countershock
Female
Follow-Up Studies
Heart
Heart attacks
Heart Rate
Humans
Male
Medical sciences
Proportional Hazards Models
Substance abuse treatment
Thyroid diseases
Variables
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Summary:The objective of the current study was to determine the clinical factors that were associated with abandonment of a rate-control or a rhythm-control strategy in patients with atrial fibrillation (AF). Although the AFFIRM Study demonstrated that outcomes are similar with a primary strategy of rate-control or rhythm-control for AF, there may be clinical or demographic factors associated with abandonment of the initial treatment strategy. Knowledge of these risk factors would be useful so that patients may be given appropriate initial therapy and, as appropriate, switched to alternative treatments earlier. Patients in the AFFIRM Study were subdivided into those who were maintained on their initial treatment strategy versus those who abandoned initial treatment strategy for alternative therapies. We determined the clinical and demographic factors associated with change in initial treatment strategy. At 5 years the original treatment strategy was maintained in 85% of the patients in the rate-control arm versus 62% of those in the rhythm-control arm ( P
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2004.08.012