Attaining sinus rhythm mediates improved outcomes with early rhythm control therapy of atrial fibrillation

A mediator analysis of the EAST – AFNET 4 trial dataset revealed the key factor for the effectiveness of early rhythm control (ERC) in patients with atrial fibrillation (AF): The presence of sinus rhythm at 12 months after randomization explains 81% of the outcome-reducing effect of ERC. Other factors, e. g. blood pressure or recurrent AF, only explain small portions of the effect. The results were presented by Professor Lars Eckardt, University Hospital Münster, Germany, at the annual congress of the European Society of Cardiology (ESC) in Barcelona, Spain, on 29.08.2022 [1], [2].

Subanalysis of the EAST – AFNET 4 trial: Patients with AF and high comorbidity burden benefit from early rhythm control

Posts NEWS Fri, 29.04.2022 Subanalysis of the EAST – AFNET 4 trial: Patients with AF and high comorbidity burden benefit from early rhythm control Press release Subanalysis of the EAST – AFNET 4 trial: Patients with AF and high comorbidity burden benefit from early rhythm control Early rhythm control therapy reduces cardiovascular complications compared to … Read more

EAST – AFNET 4 trial: Patients with first diagnosed atrial fibrillation (AF) benefit from early rhythm control

Early rhythm control is useful in patients with atrial fibrillation regardless of the AF pattern. Patients with first diagnosed atrial fibrillation benefit from early rhythm control therapy comparably to patients with paroxysmal or persistent AF. This is the result of a subgroup analysis of the EAST – AFNET 4 trial that was presented by Professor Andreas Goette, St. Vincenz Hospital Paderborn, at the American Heart Association (AHA) congress on 14.11.2021 in Boston [1].

Early rhythm control improves outcomes in patients with asymptomatic atrial fibrillation

Asymptomatic patients with atrial fibrillation (AF) benefit from early rhythm control therapy comparably to symptomatic patients. This is the result of a subgroup analysis of the EAST – AFNET 4 trial that was presented by Professor Stephan Willems, Asklepios Hospital St. Georg, Hamburg, at the annual congress of the European Society of Cardiology (ESC) on 27.08.2021 [1] and published in the European Heart Journal [2].

Patients with atrial fibrillation and heart failure benefit from early rhythm control

A subgroup analysis of the EAST – AFNET 4 study population revealed: Early initiation of rhythm control therapy is associated with clinical benefit in patients with heart failure and recently diagnosed atrial fibrillation. The new findings were presented by Dr. Andreas Rillig, UKE Hamburg, at the HRS congress on 30.07.2021 [1], [2].

RESULTS: EAST-AFNET 4

Patients with newly diagnosed atrial fibrillation (AF) benefit from early rhythm control therapy, according to results of EAST – AFNET 4, an AFNET/EHRA trial presented in a Hot Line session today at ESC Congress 2020[1,2]. Early rhythm control therapy with antiarrhythmic drugs and/or AF ablation reduced a composite of cardiovascular death, stroke, and hospitalization for worsening heart failure or acute coronary syndrome in 2789 patients with early AF and cardiovascular risk factors compared to usual care over a 5-year follow-up time.