Rate control drugs differ in the prevention of progression of atrial fibrillation
| Autor: | Sander M. J. van Kuijk, Isabelle C. Van Gelder, Richard J Folkeringa, Harry J.G.M. Crijns, Jan G.P. Tijssen, Arif Elvan, Raymond Tukkie, Robert G. Tieleman, Jan Elders, Nikki A H A Pluymaekers, Tim Koldenhof, Patrick Bronzwaer, Justin G.L.M. Luermans, Michiel Rienstra, Petra Wijtvliet |
|---|---|
| Přispěvatelé: | Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Cardiologie (9), Cardiovascular Centre (CVC), Cardiology, ACS - Heart failure & arrhythmias |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Rate control medicine.drug_class Electric Countershock VERAPAMIL law.invention RACE 4 study Randomized controlled trial Atrial fibrillation progression law Physiology (medical) Internal medicine Post-hoc analysis medicine Humans Beta blocker DIGOXIN RISK Proportional hazards model business.industry Hazard ratio Atrial fibrillation medicine.disease CARDIOVERSION Treatment Outcome Cardiology Catheter Ablation Verapamil Atrial Ablation Rhythm control TACHYCARDIA Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents ARRHYTHMOGENESIS medicine.drug |
| Zdroj: | EP Europace, 24(3), 384-389. Oxford University Press Europace, 24(3). Oxford University Press Europace, 24(3), 384-389. Oxford University Press |
| ISSN: | 1099-5129 |
| Popis: | AimsWe hypothesize that in patients with paroxysmal atrial fibrillation (AF), verapamil is associated with lower AF progression compared to beta blockers or no rate control.Methods and resultsIn this pre-specified post hoc analysis of the RACE 4 randomized trial, the effect of rate control medication on AF progression in paroxysmal AF was analysed. Patients using Vaughan-Williams Class I or III antiarrhythmic drugs were excluded. The primary outcome was a composite of first electrical cardioversion (ECV), chemical cardioversion (CCV), or atrial ablation. Event rates are displayed using Kaplan–Meier curves and multivariable Cox regression analyses are used to adjust for baseline differences. Out of 666 patients with paroxysmal AF, 47 used verapamil, 383 used beta blockers, and 236 did not use rate control drugs. The verapamil group was significantly younger than the beta blocker group and contained more men than the no rate control group. Over a mean follow-up of 37 months, the primary outcome occurred in 17% in the verapamil group, 33% in the beta blocker group, and 33% in the no rate control group (P = 0.038). After adjusting for baseline characteristics, patients using verapamil have a significantly lower chance of receiving ECV, CCV, or atrial ablation compared to patients using beta blockers [hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.19–0.83] and no rate control (HR 0.64, 95% CI 0.44–0.93).ConclusionIn patients with newly diagnosed paroxysmal AF, verapamil was associated with less AF progression, as compared to beta blockers and no rate control. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|