Managing atrial fibrillation — redrawing a line in the sand

Michael J Kilborn
Med J Aust 2003; 178 (10): . || doi: 10.5694/j.1326-5377.2003.tb05319.x
Published online: 19 May 2003

The findings of two major trials show that rhythm control is not necessarily superior to rate control

  • Cardiology Department, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW.


Competing interests:

None identified.

  • 1. Kilborn MJ. Atrial fibrillation. Med J Aust 1999; 170: 498-504.
  • 2. Hohnloser SH, Kuck KH, Lilienthal J. Rhythm or rate control in atrial fibrillation. Pharmacological Intervention in Atrial Fibrillation (PIAF): a randomised trial. Lancet 2000; 356: 1789-1794.
  • 3. Wyse DG, Waldo AL, DiMarco JP, et al for the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med 2002; 347: 1825-1833.
  • 4. Van Gelder IC, Hagens VE, Bosker HA, et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. N Engl J Med 2002; 347: 1834-1840.
  • 5. Laupacis A, Boysen G, Connolly S, et al. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five ran-domized controlled trials. Arch Intern Med 1994; 154: 1449-1457.
  • 6. Page RL, Wilkinson WE, Clair WK, et al. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 1994; 89: 224-227.
  • 7. Lamas GA, Lee KL, Sweeney MO, et al. Ventricular pacing or dual-chamber pacing for sinus-node dysfunction. N Engl J Med 2002; 346: 1854-1862.
  • 8. Haïssaguerre M, Fischer B, Labbe T, et al. Frequency of recurrent atrial fibrillation after catheter ablation of overt accessory pathways. Am J Cardiol 1992; 69: 493-497.
  • 9. Shah DC, Haïssaguerre M, Jaïs P. Current perspectives on curative catheter ablation of atrial fibrillation. Heart 2002; 87: 6-8.
  • 10. Cox JL, Ad N, Palazzo T, et al. Current status of the maze procedure for the treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg 2000; 12: 15-19.
  • 11. Atrial fibrillation follow-up investigation of rhythm management – the AFFIRM study design. The Planning and Steering Committees of the AFFIRM Study for the NHLBI AFFIRM Investigators. Am J Cardiol 1997; 79: 1198-1202.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.