Efficacy of rate and rhythm control strategy in patients with atrial fibrillation: meta-analysis
10.3760/cma.j.issn.0253-3758.2012.01.015
- VernacularTitle:心房颤动中的室率控制和节律控制策略
- Author:
Shao-Jie CHEN
1
;
Yue-Hui YIN
;
Ying DONG
;
Jin-Qi FAN
;
Li SU
Author Information
1. 重庆医科大学附属第二医院
- Keywords:
Atrial fibrillation;
Heart rate;
Arrhythmia
- From:
Chinese Journal of Cardiology
2012;40(1):68-72
- CountryChina
- Language:Chinese
-
Abstract:
Objective The efficacy of rate and rhythm control strategies for treating atrial fibrillation(AF)patients was analyzed in this meta-analysis.Methods Eligible trials were searched in MEDLINE,the Cochrane Library,the Clinical Trials,the Chinese VIP database up to May 31,2010.Ten prospective randomized control trials with 7876 patients(rate control n =3932,rhythm control n =3944)were included for final analysis.Results All cause mortality(5.3％ vs.5.0％ ; OR: 1.03 ; 95％ CI:0.84-1.26; I2 ＜25％)and incidence of worsening heart failure(3.81％ vs.3.61％ ; OR: 1.04; 95％ CI:0.80-1.36; I2 ＜ 50％)were similar between the two groups.Subgroup analysis showed that all cause mortality(3.6％ vs.1.9％ ; OR: 1.89; 95％ CI: 1.01-3.53; I2 ＜25％)and rate of worsening heart failure (2.3％ vs.0.3％ ; OR: 5.6 ; 95％ CI: 1.44-21.69 ; I2 ＜ 25％)were significantly higher in rate control group than in rhythm control group in patients with age ＜ 65 years.Thromboembolic events(1.49％ vs.1.46％ ; OR: 1.02,95％ CI: 0.71-1.48)and bleeding events(1.78％ vs.1.73％ ; OR: 1.02,95％CI:0.70-1.49)were similar between rhythm control and rate control groups while rehospitalization rate was significantly lower in rate control group than in rhythm control group(17.56％ vs.22.98％ ; OR: 0.37,95％ CI: 0.19-0.71).Conclusion This meta-analysis shows that rhythm control strategy is superior to rate control strategy for AF patients with age ＜ 65 years in terms of reducing all cause mortality and incidence of worsening heart failure.
