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


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...



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.


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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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