AF-CHF Trial

BySteven Lome, MD

Trial Details

Acronym: Atrial Fibrillation-Congestive Heart Failure trial

Purpose: Evaluate the impact of beta-blockers on hospitalization and mortality in patients with atrial fibrillation and congestive HF.

Format: Randomized, open-label, parallel assignment

Study Group 1: Beta-blockers at baseline

Study Group 2: No beta-blockers at baseline

Number of Patients: 1,376

Centers: 123

Countries: Canada

Inclusion Criteria:

Left ventricular ejection fraction (LVEF) ≤35% with symptomatic congestive heart failure OR a LVEF <25%
One electrocardiographically documented episode of AF that lasted >6 h OR required cardioversion in the preceding 6 months, OR an episode of AF that lasted >10 min in the preceding 6 months combined with cardioversion for AF at any time
AF that persisted for >12 months qualified if sinus rhythm could be maintained for >24 h following cardioversion

Primary Endpoint: all-cause mortality

Secondary Endpoints:

cardiovascular mortality
all-cause hospitalizations
cardiovascular hospitalizations
hospitalizations for worsening heart failure

Follow-up: Median 37 months

Summary:

Beta-blockers were associated with lower all-cause mortality but did not impact hospitalizations. In sensitivity analyses using beta-blockers as a time-dependent variable, the results were similar. There were no interactions for either outcome between beta-blockers and burden of AF or pattern of AF.

Original Publication:

Cadrin-Tourigny J, et al. JACC Heart Fail. 2017;doi:10.1016/j.jchf.2016.10.015.