Rhythm Control Versus Rate Control for New Onset Atrial Fibrillation

Study Overview
=================
Brief Summary
-----------------
Adult patients who are diagnosed new onset atrial fibrillation with rapid ventricular response within 7 days after non-cardiac non-thoracic surgery are enrolled.

Detailed Description
-----------------
After randomization, they are allocated to rhythm control strategy group or rate control strategy group. In rhythm control strategy group, patients are given amiodarone primarily for the purpose of sinus conversion of cardiac rhythm. In rate control strategy group, patients are given diltiazem or esmolol for the purpose of rate control. the rate of sinus conversion within 48 hours after treatment are compared.

Official Title
-----------------
Rhythm Control Versus Rate Control for New Onset Atrial Fibrillation After Non-cardiac Non-thoracic Surgery

Conditions
-----------------
Atrial Fibrillation New Onset, Atrial Fibrillation Paroxysmal

Intervention / Treatment
-----------------
* Drug: Amiodarone, diltiazem or esmolol


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Older than 18 years Newly diagnosed atrial fibrillation or flutter Patients with atrial fibrillation or flutter that occurred within 7 days after non-cardiac non-thoracic surgery Atrial fibrillation or flutter with rapid ventricular response(HR ≥110/min) Patients without hemodynamic instability (MBP≥65mmHg with norepinephrine continuous infusion less than 5mcg/min or without vasopressor support) Exclusion Criteria: Atrial fibrillation or flutter prolonged more than 48 hours without anticoagulation Patients who have decreased cardiac function or heart failure (EF <40%) Patients who have cardiac conduction disorder, QT prolongation(QTc ≥500ms)

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Single blinded randomized controlled trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rate control strategy group<br>Patients are given diltiazem or esmolol to control heart rate less than 110/min. | Drug: Amiodarone, diltiazem or esmolol<br>* Intravenous continuous infusion after loading or bolus dose of amiodarone, diltiazem or esmolol.<br>* Other names: herben;|
| Experimental: Rhythm control strategy group<br>Patients are given amiodarone for conversion of cardiac rhythm to sinus rhythm. | Drug: Amiodarone, diltiazem or esmolol<br>* Intravenous continuous infusion after loading or bolus dose of amiodarone, diltiazem or esmolol.<br>* Other names: herben;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of sinus conversion | Rate of sinus conversion within 48 hours | within 48 hrs | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to first sinus conversion | Time to first sinus conversion | during the same admission period | 
| Recurrence of atrial fibrillation | Recurrence of atrial fibrillation during the same admission period | during the same admission period |