Rate control drugs differ in the prevention of progression of atrial fibrillation

• DOI: 10.1093/ehjci/ehaa946.0403
• Publication Date: 2020-11-26T13:08:17Z
• Authors: T Koldenhof; E.P.J.P Wijtvliet; N.A.H.A Pluymaekers; M Rienstra; R.J Folkeringa; P Bronzwaer; A Elvan; J Elders; R Tukkie; J.G.L.M Luermans; I.C Van Gelder; H.J.G.M Crijns; R.G Tieleman
• Keywords: Post-hoc analysis; Antiarrhythmic agent

Abstract Background In patients with paroxysmal atrial fibrillation (PAF), verapamil reduces progression to persistent AF through its intracellular calcium-lowering effects. Little is known on the effects of beta-blockade. Methods this pre-specified post-hoc analysis RACE4 randomised trial (nurse-led care versus usual-care in newly detected AF) all PAF and treated beta-blockers or for rate control, were analyzed. Patients using class I III antiarrhythmic drugs excluded. The primary outcome was time first electrical cardioversion (ECV) non-selfterminating AF. Event rates are reported Kaplan-Meier analysis, multivariate used correct baseline differences. Results Out 430 PAF, 383 47 verapamil. Compared patients, beta-blocker significantly older (60±12 66±9 years), had a higher CHA2DS2-VASc score (1.5 2.0) lower left ventricular ejection fraction (60% 55%). There no other significant differences between two groups. Over mean follow up 36 months, 99 out (23%) underwent ECV after group 95 (25%) ECV, compared 4 (9%) (P=0.013, Figure 1). After correction remained associated less (OR 0.23, confidence interval 0.08 0.67). Similarly, chemical cardioversion, whichever came first, performed 113 (30%) 7 (15%) (P=0.022). total 35 ablations performed, 34 only 1 (2%) (p=0.075). Conclusion diagnosed AF, as beta-blockers. order draw firm conclusions, these results need be confirmed by prospective study free survival Funding Acknowledgement Type funding source: None