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Determinants of sinus rhythm maintenance in patients with early-persistent atrial fibrillation and heart failure

  • Ruben R. de WithEmail author
  • Michiel Rienstra
  • Harry J. G. M. Crijns
  • Isabelle C. Van Gelder
  • for the RACE 3 investigators
Letter to the Editors

Sirs:

Atrial fibrillation (AF) and heart failure (HF) often coexist. Rate versus rhythm control trials showed no differences in outcome, which can in part be accounted for the inability to maintain sinus rhythm, and lack of direct interference of antiarrhythmic drugs with cardiovascular risk factors underlying AF progression [1]. It has been shown that the more advanced types of AF have worse outcome, suggesting that sinus rhythm maintenance may be of importance [2]. Recently, the Routine versus Aggressive risk factor-driven upstream rhythm Control for prevention of Early atrial fibrillation in heart failure (RACE 3) trial showed that the targeted therapy of underlying conditions was superior in sinus rhythm maintenance during 1-year follow-up in patients with early-persistent AF and HF [3]. In the current manuscript, we aimed to identify factors associated with sinus rhythm maintenance in patients with a short history of persistent AF and HF included in the RACE 3.

The RACE 3 design...

Notes

Funding

The study is supported by the Netherlands Heart Foundation (Grant 2008B035). Unrestricted grants from AstraZeneca, Bayer, Biotronik, Boehringer-Ingelheim, Boston Scientific, Medtronic, Sanofi-Aventis, St. Jude Medical paid to the Netherlands Heart Institute. The authors have nothing to disclose.

References

  1. 1.
    Roy D, Talajic M, Nattel S et al (2008) Rhythm control versus rate control for atrial fibrillation and heart failure. N Engl J Med 358:2667–2677CrossRefGoogle Scholar
  2. 2.
    Vanassche T, Lauw MN, Eikelboom JW et al (2015) Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES. Eur Heart J 36:281–287CrossRefGoogle Scholar
  3. 3.
    Rienstra M, Hobbelt AH, Alings M et al (2018) Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. Eur Heart J 39:2987–2996CrossRefGoogle Scholar
  4. 4.
    Kirchhof P, Benussi S, Kotecha D et al (2016) 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 18:1609–1678CrossRefGoogle Scholar
  5. 5.
    Weijs B, Pisters R, Haest RJ et al (2012) Patients originally diagnosed with idiopathic atrial fibrillation more often suffer from insidious coronary artery disease compared to healthy sinus rhythm controls. Heart Rhythm 9:1923–1929CrossRefGoogle Scholar
  6. 6.
    Hobbelt AH, Spronk HM, Crijns HJGM, Ten Cate H, Rienstra M, Van Gelder IC (2017) Prethrombotic state in young very low-risk patients with atrial fibrillation. J Am Coll Cardiol 69:1990–1992CrossRefGoogle Scholar
  7. 7.
    Spronk HM, De Jong AM, Verheule S et al (2016) Hypercoagulability causes atrial fibrosis and promotes atrial fibrillation. Eur Heart J 38:38–50CrossRefGoogle Scholar
  8. 8.
    Echouffo-Tcheugui JB, Shrader P, Thomas L et al (2017) Care patterns and outcomes in atrial fibrillation patients with and without diabetes: ORBIT-AF registry. J Am Coll Cardiol 70:1325–1335CrossRefGoogle Scholar
  9. 9.
    Fatemi O, Yuriditsky E, Tsioufis C et al (2014) Impact of intensive glycemic control on the incidence of atrial fibrillation and associated cardiovascular outcomes in patients with type 2 diabetes mellitus (from the action to control cardiovascular risk in diabetes study). Am J Cardiol 114:1217–1222CrossRefGoogle Scholar
  10. 10.
    Wang A, Green JB, Halperin JL, Piccini JP (2019) Atrial fibrillation and diabetes mellitus: JACC review topic of the week. J Am Coll Cardiol.  https://doi.org/10.1016/j.jacc.2019.07.020 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ruben R. de With
    • 1
    Email author
  • Michiel Rienstra
    • 1
  • Harry J. G. M. Crijns
    • 2
  • Isabelle C. Van Gelder
    • 1
  • for the RACE 3 investigators
  1. 1.Department of CardiologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  2. 2.Department of CardiologyMaastricht University Medical Center+MaastrichtThe Netherlands

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