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ACC: Rate, Rhythm Control Both Effective for Post-Op A-Fib

Equal number of days of hospitalization, similar complication and persistent a-fib rates

TUESDAY, April 5, 2016 (HealthDay News) — For patients with new-onset postoperative atrial fibrillation, outcomes are similar for rate control and rhythm control, according to a study published online April 4 in the New England Journal of Medicine. The research is being published to coincide with the annual meeting of the American College of Cardiology, held from April 2 to 4 in Chicago.

A. Marc Gillinov, M.D., from the Cleveland Clinic Foundation, and colleagues randomized patients with new onset postoperative atrial fibrillation to undergo rate control or rhythm control. Postoperative atrial fibrillation occurred in 695 of 2,109 prospectively enrolled patients, of whom 523 underwent randomization.

The researchers found that the total numbers of hospital days were similar between the groups (median, 5.1 days for rate control and 5.0 for rhythm control; P = 0.76). No significant between-group differences were seen in the rates of death (P = 0.64) or overall serious adverse events (P = 0.61). In each group, about 25 percent of patients deviated from the assigned therapy. Overall, 93.8 and 97.9 percent of patients in the rate-control and rhythm-control groups, respectively, had had a stable heart rhythm without atrial fibrillation for the previous 30 days at 60 days (P = 0.02), and 84.2 and 86.9 percent, respectively, had been free from atrial fibrillation from discharge to 60 days (P = 0.41).

“Neither treatment strategy showed a net clinical advantage over the other,” the authors write.

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