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Medical therapy for rhythm control, rate control increased quality of life in patients with AF
Medical therapy for rhythm control or rate control was associated with improved health-related quality of life in patients with recent onset of atrial fibrillation, according to new data from the RECORD-AF registry.
The researchers wrote that “the magnitude of [health-related quality of life] improvement was minimally higher in patients treated with rhythm control than rate control,” but “the overall degree of improvement was not large, and its clinical significance was uncertain.”
In a prespecified substudy of the RECORD-AF registry, the researchers administered an AF-specific health-related quality of life questionnaire to 2,439 patients diagnosed with AF for less than 1 year. Scores ranged from 0 to 35, with higher numbers signifying more severe symptoms, and were taken at baseline and at 1 year.
Patients were stratified according to whether they were treated with medical rhythm control (defined as class I antiarrhythmic drugs, sotalol or other class III antiarrhythmic drugs) or with medical rate control (defined as use of an atrioventricular nodal blocker [nonsotalol beta-blocker, calcium channel blocker or digoxin] without use of a class I or III antiarrhythmic agent).
Using a propensity-score adjusted longitudinal analysis, Andrew C.T. Ha, MD, MSc, and colleagues compared the change to AF symptom severity scores between the two treatment groups.
During a mean follow-up of 1 year, the AF symptom severity scores improved in both the rhythm control group (–2.82 points; 95% CI, –3.22 to –2.41) and the rate control group (–2.11 points; 95% CI, –2.54 to –1.67), Ha, from the department of medicine at the University of Toronto, and colleagues found.
According to the researchers, the magnitude of improvement was higher in the rhythm control group than in the rate control group (propensity score-adjusted difference, –0.71 points; 95% CI, –1.31 to –0.11).
Results from previous studies had indicated no difference in health-related quality of life improvement between patients with AF treated with rate or rhythm control, but those studies used generic health-related quality of life questionnaires that may not be as sensitive or as specific as the AF-specific questionnaire used in the present study, Ha and colleagues wrote. Also, they wrote, those studies were based on subgroups of randomized clinical trial populations, and not on registry populations.
Disclosure: The registry was funded by Sanofi. Several researchers report financial ties with Sanofi.