Publication:
Benefits of Rhythm Control and Rate Control in Recent-onset Atrial Fibrillation: The HERMES-AF Study.

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2019-03-06

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Martín, Alfonso
Coll-Vinent, Blanca
Suero, Coral
Fernández-Simón, Amparo
Sánchez, Juan
Varona, Mercedes
Cancio, Manuel
Sánchez, Susana
Carbajosa, José
Malagón, Francisco

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Abstract

Although rhythm control has failed to demonstrate long-term benefits over rate control in longstanding episodes of atrial fibrillation (AF), there is little evidence concerning recent-onset ones. We analyzed the benefits of rhythm and rate control in terms of symptoms alleviation and need for hospital admission in patients with recent-onset AF. This was a multicenter, observational, cross-sectional study with prospective standardized data collection carried out in 124 emergency departments (EDs). Clinical variables, treatment effectiveness, and outcomes (control of symptoms, final disposition) were analyzed in stable patients with recent-onset AF consulting for AF-related symptoms. Of 421 patients included, rhythm control was chosen in 352 patients (83.6%), a global effectiveness of 84%. Rate control was performed in 69 patients (16.4%) and was achieved in 67 (97%) of them. Control of symptoms was achieved in 396 (94.1%) patients and was associated with a heart rate after treatment ≤ 110 beats/min (odds ratio [OR] = 14.346, 95% confidence interval [CI] = 3.90 to 52.70, p 110 beats/min after treatment (OR = 29.71, 95% CI = 7.19 to 123.07, p In our study, recent-onset AF patients in whom rhythm control was attempted in the ED had a high rate of symptoms' alleviation and a reduced rate of hospital admissions.

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Aged
Anti-Arrhythmia Agents
Atrial Fibrillation
Cross-Sectional Studies
Emergency Service, Hospital
Female
Heart Rate
Hospitalization
Humans
Male
Middle Aged
Prospective Studies
Treatment Outcome

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