Early Rhythm-Control Therapy in Patients with Atrial Fibrillation

Abstract

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Type of atrial fibrillation and outcomes in patients without oral anticoagulants

“…Recently, several papers have shown a reduction in all‐cause mortality, hospitalization for heart failure or the composite endpoint of adverse outcomes with AF catheter ablation in patients with reduced ejection fraction 28‐30 . Furthermore, the newest published results of EAST‐AFNET 4 Trial 31 demonstrated that early rhythm control based on the usual care for AF could reduce the incidence of adverse outcomes including cardiovascular death, stroke, hospitalization for heart failure and acute coronary syndrome(HR 0.79, 95%CI 0.66–0.94, p = .005). The literature suggested that reducing the burden of AF can improve prognosis.…”

Revisiting Antiarrhythmic Drug Therapy for Atrial Fibrillation: Reviewing Lessons Learned and Redefining Therapeutic Paradigms

“…The progressive nature of AF atriomyopathy implies a critical need for early rhythm-control therapy in AF because timing matters in preventing or delaying the progression of AF atriomyopathy. This paradigm-shifting therapeutic strategy is most recently validated by the Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST-AFNET 4), an international, randomized, open, blinded-outcome-assessment clinical trial (Kirchhof et al, 2020). In fact, the most recently published 2020 AF guidelines mark a revolutionizing paradigm shift in management strategies because the pressing need for primary prevention to thwart AF atriomyopathy onset is emphasized for the first time (Hindricks et al, 2020).…”

Lo mejor del Congreso 2020 de la Sociedad Europea de Cardiología: la experiencia digital

“…Con estos antecedentes el Dr. Paulos Kirchhof y colaboradores diseñaron el estudio EAST-AFNET 4 (7) (Early Rhythm-Control Therapy in Patients with Atrial Fibrillation), que buscaba probar si la estrategia temprana de control del ritmo, que incluía ablación de FA, se podría asociar con mejores resultados en pacientes con FA temprana, en comparación al tratamiento contemporáneo basado en la evidencia. EAST-AFNET 4 fue un estudio basado en eventos, multicéntrico, randomizado, abierto (con comité de valoración de eventos ciego).…”