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What can rhythm control therapy contribute to prognosis in atrial fibrillation?
  1. Sascha Rolf1,
  2. Jelena Kornej1,
  3. Nikolaos Dagres2,
  4. Gerhard Hindricks1
  1. 1Department of Electrophysiology, University of Leipzig—Heart Center, Leipzig, Germany
  2. 2Second University Department of Cardiology, University of Athens, Attikon University Hospital, Athens, Greece
  1. Correspondence to Dr Sascha Rolf, Department of Electrophysiology, University of Leipzig—Heart Center, Struempellstr. 39, Leipzig 04289, Germany; sascha.rolf{at}web.de

Abstract

Atrial fibrillation (AF) is a global healthcare problem of growing prevalence and major significance. The consequences of AF include an increased rate of death, stroke and heart failure. Theoretically, a therapeutic strategy aiming at restoration and maintenance of sinus rhythm should offset the prognosis impairment associated with AF. However, these expectations were disproven in large randomised controlled trials comparing conventional antiarrhythmic drugs for rhythm control with conventional rate control. These apparently contradictory findings suggest that rhythm control strategies require better therapeutic instruments. These improvements may involve drugs and/or interventions with optimised risk–benefit profile and which also appreciate the specific atrial pathology and the patient's comorbidities. This article addresses important aspects of rhythm control strategies, which may have the potential of a beneficial contribution to the prognosis of AF patients.

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