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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses results from the REgistry on Cardiac rhythm disORDers: an international observational prospective survey assessing the control of Atrial Fibrillation (RecordAF) registry that confirmed and complemented results from previous controlled randomized trials.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EArrhythmias Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe clinical outcomes that are associated with rate control versus the restoration and maintenance of normal sinus rhythm in the treatment of atrial fibrillation (AF) have been explored in a number of large-scale clinical trials [Wyse DG et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2002; Van Gelder et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2002]. No advantages for either treatment strategy with respect to major cardiovascular (CV) outcomes have been reported. John Camm, MD, St. George\u0027s Hospital Medical School, London, UK, reported results from a reallife, international, observational, prospective, longitudinal cohort study that confirmed and complemented results from these previous controlled randomized trials.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe RecordAF (REgistry on Cardiac rhythm disORDers: an international observational prospective survey assessing the control of Atrial Fibrillation) registry was established to trace the influence of a physician\u0027s choice of a rate versus rhythm control strategy on clinical outcome for patients with first onset or recent recurrent AF. Patients (n=5604) aged 18 years and older with a \u0026lt;1-year history of AF were selected from 532 randomly chosen general cardiology practices in 21 countries. Patients with permanent or transient AF were not eligible. The primary study endpoint was the rate of therapeutic success of AF management (in sinus rhythm or at rate control target with no major CV event and no change in strategy) at 12 months. The co-primary endpoint was the rate of major CV events (eg, CV death, myocardial infarction, stroke, transient ischemic attack [TIA], and hospitalizations).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAt baseline, 45.1% (n=2528) of patients in the registry were being treated with a rate control strategy and 54.9% (n=3076) were treated with a rhythm control strategy. Patients in the rhythm control group were an average of 3 years younger than those on rate control (64 vs 67 years; p\u0026lt;0.001) and had a significantly (p\u0026lt;0.001) lower resting heart rate (76.6 vs 80.6 beats per minute). Body mass index and systolic blood pressure were slightly but significantly (p=0.008 and p=0.02, respectively) greater in the rhythm control group.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EData for 92.3% of patients were available after 1 year of follow-up, at which time more patients in the rhythm control group were in sinus rhythm (81% vs 33%). Approximately 50% of patients had a change in pharmacological treatment and 20% had a change in therapeutic strategy in both groups. Therapeutic success was achieved significantly (p\u0026lt;0.001) more frequently in patients who were treated by rhythm control (60% vs 47%), which was driven by control of AF (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). For the co-primary endpoint, there was no difference (p=0.35) between the two strategies in terms of overall clinical events (18% in rate control vs 17% in rhythm control groups). Multivariate analysis showed that the occurrence of cardiovascular clinical events was more dependent on comorbidity (coronary artery disease, heart failure, age \u0026gt;75 years, renal disease, prior stroke\/TIA) than the choice of strategy. Hospitalizations for arrhythmia were more common in the rhythm (11%) versus rate control group (7%), and hospitalizations for heart failure management were more common in the rate (5%) versus rhythm control group (2%).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/20\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Primary Endpoint at One Year.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-437342672\u0022 data-figure-caption=\u0022Primary Endpoint at One Year.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/20\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/20\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/5\/20\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11428\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EPrimary Endpoint at One Year.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission by J. Camm, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EProf. Camm concluded that although successful management of AF was achieved more often with rhythm control, this did not translate into better outcomes.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2009 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/9\/5\/20.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmi3q\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmi3q\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}