Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)

A John Camm; Günter Breithardt; Harry Crijns; Paul Dorian; Peter Kowey; Jean-Yves Le Heuzey; Ihsen Merioua; Laurence Pedrazzini; Eric N Prystowsky; Peter J Schwartz; Christian Torp-Pedersen; William Weintraub

doi:http://dx.doi.org/10.1016/j.jacc.2011.03.034

Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)

A John Camm, Günter Breithardt, Harry Crijns, Paul Dorian, Peter Kowey, Jean-Yves Le Heuzey, Ihsen Merioua, Laurence Pedrazzini, Eric N Prystowsky, Peter J Schwartz, Christian Torp-Pedersen, William Weintraub

122 Citations (Scopus)

Abstract

Objectives: RECORDAF is the first worldwide, prospective, observational survey of management of atrial fibrillation (AF) in unselected, community-based patients. Background: Primary outcomes were therapeutic success and clinical outcomes associated with rhythm-control and rate-control strategies. Methods: Patients with recent-onset AF were included (n = 5,604). Treatment strategy (rhythm control or rate control) was noted at baseline. Follow-up was 12 months. Therapeutic success required that strategy was unchanged without clinical events. Further maintenance of sinus rhythm was required in the rhythm-control group, and heart rate ≤80 beats/min in the rate-control group. Results: Data from 5,171 patients were assessable. Therapeutic success was 54% overall (rhythm control 60% vs. rate control 47%), a result driven by control of AF: rhythm control, 81% vs. rate control, 74%. After adjustment for propensity score quintiles, the rhythm-control strategy was significantly related to superior therapeutic success (odds ratio: 1.34, 95% confidence interval: 1.15 to 1.55; p = 0.0002). Clinical events occurred in 18% of patients. The arrhythmia management strategy was not predictive of clinical events. The type (persistent), presence at baseline visit, and duration (>3 months) of AF, together with age older than 75 years and the presence of heart failure, predicted progression to permanent AF. The choice of rhythm control reduced the likelihood of AF progression (odds ratio: 0.20, 95% confidence interval: 0.17 to 0.25; p < 0.0001). Conclusions: Clinical outcomes in AF patients were driven mainly by hospitalizations for arrhythmia/proarrhythmia and other cardiovascular causes, but not by the choice of rate or rhythm strategy. Rhythm-control patients progressed less rapidly to permanent AF.

Original language	English
Journal	Journal of the American College of Cardiology
Volume	58
Issue number	5
Pages (from-to)	493-501
Number of pages	9
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2011.03.034
Publication status	Published - 26 Jul 2011

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Camm, A. J., Breithardt, G., Crijns, H., Dorian, P., Kowey, P., Le Heuzey, J-Y., Merioua, I., Pedrazzini, L., Prystowsky, E. N., Schwartz, P. J., Torp-Pedersen, C., & Weintraub, W. (2011). Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation). Journal of the American College of Cardiology, 58(5), 493-501. https://doi.org/10.1016/j.jacc.2011.03.034

Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation). / Camm, A John; Breithardt, Günter; Crijns, Harry et al.

In: Journal of the American College of Cardiology, Vol. 58, No. 5, 26.07.2011, p. 493-501.

Research output: Contribution to journal › Journal article › Research › peer-review

Camm, AJ, Breithardt, G, Crijns, H, Dorian, P, Kowey, P, Le Heuzey, J-Y, Merioua, I, Pedrazzini, L, Prystowsky, EN, Schwartz, PJ, Torp-Pedersen, C & Weintraub, W 2011, 'Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)', Journal of the American College of Cardiology, vol. 58, no. 5, pp. 493-501. https://doi.org/10.1016/j.jacc.2011.03.034

Camm AJ, Breithardt G, Crijns H, Dorian P, Kowey P, Le Heuzey J-Y et al. Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation). Journal of the American College of Cardiology. 2011 Jul 26;58(5):493-501. doi: http://dx.doi.org/10.1016/j.jacc.2011.03.034

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title = "Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)",

abstract = "Objectives: RECORDAF is the first worldwide, prospective, observational survey of management of atrial fibrillation (AF) in unselected, community-based patients. Background: Primary outcomes were therapeutic success and clinical outcomes associated with rhythm-control and rate-control strategies. Methods: Patients with recent-onset AF were included (n = 5,604). Treatment strategy (rhythm control or rate control) was noted at baseline. Follow-up was 12 months. Therapeutic success required that strategy was unchanged without clinical events. Further maintenance of sinus rhythm was required in the rhythm-control group, and heart rate ≤80 beats/min in the rate-control group. Results: Data from 5,171 patients were assessable. Therapeutic success was 54% overall (rhythm control 60% vs. rate control 47%), a result driven by control of AF: rhythm control, 81% vs. rate control, 74%. After adjustment for propensity score quintiles, the rhythm-control strategy was significantly related to superior therapeutic success (odds ratio: 1.34, 95% confidence interval: 1.15 to 1.55; p = 0.0002). Clinical events occurred in 18% of patients. The arrhythmia management strategy was not predictive of clinical events. The type (persistent), presence at baseline visit, and duration (>3 months) of AF, together with age older than 75 years and the presence of heart failure, predicted progression to permanent AF. The choice of rhythm control reduced the likelihood of AF progression (odds ratio: 0.20, 95% confidence interval: 0.17 to 0.25; p < 0.0001). Conclusions: Clinical outcomes in AF patients were driven mainly by hospitalizations for arrhythmia/proarrhythmia and other cardiovascular causes, but not by the choice of rate or rhythm strategy. Rhythm-control patients progressed less rapidly to permanent AF.",

author = "Camm, {A John} and G{\"u}nter Breithardt and Harry Crijns and Paul Dorian and Peter Kowey and {Le Heuzey}, Jean-Yves and Ihsen Merioua and Laurence Pedrazzini and Prystowsky, {Eric N} and Schwartz, {Peter J} and Christian Torp-Pedersen and William Weintraub",

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T1 - Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)

AU - Camm, A John

AU - Breithardt, Günter

AU - Crijns, Harry

AU - Dorian, Paul

AU - Kowey, Peter

AU - Le Heuzey, Jean-Yves

AU - Merioua, Ihsen

AU - Pedrazzini, Laurence

AU - Prystowsky, Eric N

AU - Schwartz, Peter J

AU - Torp-Pedersen, Christian

AU - Weintraub, William

PY - 2011/7/26

Y1 - 2011/7/26

N2 - Objectives: RECORDAF is the first worldwide, prospective, observational survey of management of atrial fibrillation (AF) in unselected, community-based patients. Background: Primary outcomes were therapeutic success and clinical outcomes associated with rhythm-control and rate-control strategies. Methods: Patients with recent-onset AF were included (n = 5,604). Treatment strategy (rhythm control or rate control) was noted at baseline. Follow-up was 12 months. Therapeutic success required that strategy was unchanged without clinical events. Further maintenance of sinus rhythm was required in the rhythm-control group, and heart rate ≤80 beats/min in the rate-control group. Results: Data from 5,171 patients were assessable. Therapeutic success was 54% overall (rhythm control 60% vs. rate control 47%), a result driven by control of AF: rhythm control, 81% vs. rate control, 74%. After adjustment for propensity score quintiles, the rhythm-control strategy was significantly related to superior therapeutic success (odds ratio: 1.34, 95% confidence interval: 1.15 to 1.55; p = 0.0002). Clinical events occurred in 18% of patients. The arrhythmia management strategy was not predictive of clinical events. The type (persistent), presence at baseline visit, and duration (>3 months) of AF, together with age older than 75 years and the presence of heart failure, predicted progression to permanent AF. The choice of rhythm control reduced the likelihood of AF progression (odds ratio: 0.20, 95% confidence interval: 0.17 to 0.25; p < 0.0001). Conclusions: Clinical outcomes in AF patients were driven mainly by hospitalizations for arrhythmia/proarrhythmia and other cardiovascular causes, but not by the choice of rate or rhythm strategy. Rhythm-control patients progressed less rapidly to permanent AF.

AB - Objectives: RECORDAF is the first worldwide, prospective, observational survey of management of atrial fibrillation (AF) in unselected, community-based patients. Background: Primary outcomes were therapeutic success and clinical outcomes associated with rhythm-control and rate-control strategies. Methods: Patients with recent-onset AF were included (n = 5,604). Treatment strategy (rhythm control or rate control) was noted at baseline. Follow-up was 12 months. Therapeutic success required that strategy was unchanged without clinical events. Further maintenance of sinus rhythm was required in the rhythm-control group, and heart rate ≤80 beats/min in the rate-control group. Results: Data from 5,171 patients were assessable. Therapeutic success was 54% overall (rhythm control 60% vs. rate control 47%), a result driven by control of AF: rhythm control, 81% vs. rate control, 74%. After adjustment for propensity score quintiles, the rhythm-control strategy was significantly related to superior therapeutic success (odds ratio: 1.34, 95% confidence interval: 1.15 to 1.55; p = 0.0002). Clinical events occurred in 18% of patients. The arrhythmia management strategy was not predictive of clinical events. The type (persistent), presence at baseline visit, and duration (>3 months) of AF, together with age older than 75 years and the presence of heart failure, predicted progression to permanent AF. The choice of rhythm control reduced the likelihood of AF progression (odds ratio: 0.20, 95% confidence interval: 0.17 to 0.25; p < 0.0001). Conclusions: Clinical outcomes in AF patients were driven mainly by hospitalizations for arrhythmia/proarrhythmia and other cardiovascular causes, but not by the choice of rate or rhythm strategy. Rhythm-control patients progressed less rapidly to permanent AF.

U2 - http://dx.doi.org/10.1016/j.jacc.2011.03.034

DO - http://dx.doi.org/10.1016/j.jacc.2011.03.034

M3 - Journal article

SN - 0735-1097

VL - 58

SP - 493

EP - 501

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 5

ER -

Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)

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