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document
Mending the rhythm does not improve prognosis in patients with persistent atrial fibrillation : a subanalysis of the RACE study . AIMS To compare outcome of AF patients with effective rhythm control with patients treated with rate control . METHODS AND RESULTS Out of the 266 AF patients randomized to rhythm control in the RACE study , 49 patients turned to long-term sinus rhythm and were continuously treated with oral anticoagulation . The incidence of the primary endpoint in these patients was compared to that in 178 patients out of the initial 256 rate-control patients of RACE who were in AF and using oral anticoagulation continuously . Baseline characteristics of both groups were not different . After a mean follow-up of 2.3+/-0.6 years , the primary endpoint ( a composite of cardiovascular mortality , heart failure , thrombo-embolic complications ( TECs ) , bleeding , serious adverse effects of antiarrhythmic drugs and pacemaker implants ) was 22.4 % in the rhythm-control group vs. 15.2 % in the rate-control group . Multivariable regression analysis indicated coronary artery disease , heart failure , and digitalis as independent risk indicators of cardiovascular morbidity and mortality . Chronic sinus rhythm did not matter . CONCLUSION Among patients who remained on warfarin , those who mostly were maintained in sinus rhythm under a rhythm-control strategy did not have a superior prognosis compared to those who remained in AF under a rate-control strategy .
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Intervention_Physical
rhythm control
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Intervention_Physical
long-term sinus rhythm
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Intervention_Pharmacological
oral anticoagulation
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Intervention_Pharmacological
warfarin
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Outcome_Physical
composite of cardiovascular mortality
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Outcome_Physical
heart failure
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Outcome_Physical
thrombo-embolic complications ( TECs )
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Outcome_Physical
bleeding
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Outcome_Adverse-effects
serious adverse effects of antiarrhythmic drugs
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Outcome_Adverse-effects
pacemaker implants
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Outcome_Physical
coronary artery disease
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Outcome_Physical
digitalis
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Outcome_Physical
Chronic sinus rhythm
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Participant_Condition
persistent atrial fibrillation
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Participant_Condition
AF
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Participant_Sample-size
266
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Participant_Sample-size
49
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Participant_Sample-size
256