In patients with AF and HF , rate control compared with rhythm control showed inferior risk of hospitalisation
BACKGROUND Atrial fibrillation ( AF ) is a common arrhythmia that can promote or worsen heart failure ( HF ) .
Our purpose was to compare the effects of rate and rhythm control in patients with atrial fibrillation and heart failure .
A short-term, randomized, double-blind, parallel-group study to evaluate the efficacy and safety of dronedarone versus amiodarone in patients with persistent atrial fibrillation: the DIONYSOS study.
INTRODUCTION We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation ( AF ) . METHODS Five hundred and four amiodarone-naïve patients were r and omized to receive dronedarone 400 mg bid ( n = 249 ) or amiodarone 600 mg qd for 28 days then 200 mg qd ( n = 255 ) for at least 6 months . Primary composite endpoint was recurrence of AF ( including unsuccessful electrical cardioversion , no spontaneous conversion and no electrical cardioversion ) or premature study discontinuation . Main safety endpoint ( MSE ) was occurrence of thyroid- , hepatic- , pulmonary- , neurologic- , skin- , eye- , or gastrointestinal-specific events , or premature study drug discontinuation following an adverse event . RESULTS Median treatment duration was 7 months . The primary composite endpoint was 75.1 and 58.8 % with dronedarone and amiodarone , respectively , at 12 months ( hazard ratio [ HR ] 1.59 ; 95 % confidence interval [ CI ] 1.28 - 1.98 ; P < 0.0001 ) , mainly driven by AF recurrence with dronedarone compared with amiodarone ( 63.5 vs 42.0 % ) . AF recurrence after successful cardioversion was 36.5 and 24.3 % with dronedarone and amiodarone , respectively . Premature drug discontinuation tended to be less frequent with dronedarone ( 10.4 vs 13.3 % ) . MSE was 39.3 and 44.5 % with dronedarone and amiodarone , respectively , at 12 months ( HR = 0.80 ; 95 % CI 0.60 - 1.07 ; P = 0.129 ) , and mainly driven by fewer thyroid , neurologic , skin , and ocular events in the dronedarone group . CONCLUSION In this short-term study , dronedarone was less effective than amiodarone in decreasing AF recurrence , but had a better safety profile , specifically with regard to thyroid and neurologic events and a lack of interaction with oral anticoagulants
In patients with AF and HF , rate control compared with rhythm control showed inferior risk of hospitalisation
BACKGROUND Atrial fibrillation ( AF ) is a common arrhythmia that can promote or worsen heart failure ( HF ) .
Our purpose was to compare the effects of rate and rhythm control in patients with atrial fibrillation and heart failure .