Fast Five Quiz: Stroke Prevention in Atrial Fibrillation

Brian Silver, MD


September 10, 2019

Several randomized, controlled trials have shown that restoring and maintain sinus rhythm in patients with AFib neither improves the survival rate nor reduces the risk for stroke. The AFFIRM study enrolled 4060 patients aged ≥ 65 years whose AFib was likely to be recurrent and who were at risk for stroke. Patients were randomly assigned to receive to a strategy of rhythm control (cardioversion to sinus rhythm, plus one or more drugs to maintain sinus rhythm) or a strategy of rate control (in which no attempt was made to restore or maintain normal sinus rhythm).

No evidence suggested the rhythm-control strategy protected patients from stroke. An insignificant trend toward increased mortality was noted in the rate-control group. Similar findings were seen in the smaller RACE trial.

Learn more about the management of AFib here.


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