RT Journal Article SR Electronic T1 Comparison of rate control and rhythm control in patients with atrial fibrillation after percutaneous mitral balloon valvotomy: a randomised controlled study JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1096 OP 1101 DO 10.1136/hrt.2005.080325 VO 92 IS 8 A1 C L Hu A1 H Jiang A1 Q Z Tang A1 Q H Zhang A1 J B Chen A1 C X Huang A1 G S Li YR 2006 UL http://heart.bmj.com/content/92/8/1096.abstract AB Objective: To compare rate control and rhythm control strategies in patients with atrial fibrillation (AF) after percutaneous mitral balloon valvotomy (PMV). Methods: 183 patients with AF after successful PMV, with AF duration ⩽ 12 months and post-PMV left atrial (LA) size ⩽ 45 mm, were studied in a prospective, randomised trial. The primary end point was improvement in AF-related symptoms. Secondary study end points were 6 min walk tests, quality of life (QOL), normalisation of LA size, number of hospital admissions and duration of hospital stay. Results: Over one year, 2% patients in the rate control group had sinus rhythm, as compared with 96% of patients in the rhythm control group (p < 0.001). A greater proportion of patients reported improvement in symptoms in the rhythm control group than in the rate control group (p < 0.0001 at every visit time). Walking distance in a 6 min walk test, QOL and LA size normalisation were better in the rhythm control group than in the rate control group. The strategy of rhythm control was associated with similar numbers of hospital admissions but with longer duration of hospital admissions. Drug-related side effect did not differ between the rate control and rhythm control groups. During the follow-up period, no patients in either group had embolic or transitory ischaemic neurological events. Conclusions: In patients with AF after PMV, AF duration ⩽ 12 months and post-PMV LA size ⩽ 45 mm, sinus rhythm was easy and safe to achieve and maintain. Moreover, patients benefited from restoration and maintenance of sinus rhythm in terms of improved AF-related symptoms, 6 min walk tests and QOL, and of LA size normalisation. Rhythm control should therefore be considered as the preferred initial therapy for this group of patients. The optimal strategy to treat AF after PMV should be individualised.