Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Jan 2013
Review Meta AnalysisPharmacologic rate versus rhythm-control strategies in atrial fibrillation: an updated comprehensive review and meta-analysis.
In patients with atrial fibrillation (AF), ventricular rate control with medications has been found to be noninferior in preventing clinical events, compared to a strategy converting patients to sinus rhythm and maintaining it with medications. Guidelines have accepted rate control as an acceptable therapeutic option. Most of the prior studies excluded patients without significant left ventricular dysfunction, or permanent AF. ⋯ This systematic review suggests no difference in clinical outcomes with a rate or rhythm-control strategy with AF. However, rehospitalization rates appear to be lower with pharmacological rate control for all ages, while finding support for rhythm control in younger patients.