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Rhythm Control Versus Rate Control in Patients With Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction: Insights From Get With The Guidelines-Heart Failure

Authors :
Kelly, Jacob P
DeVore, Adam D
Wu, JingJing
Hammill, Bradley G
Sharma, Abhinav
Cooper, Lauren B
Felker, G Michael
Piccini, Jonathan P
Allen, Larry A
Heidenreich, Paul A
Peterson, Eric D
Yancy, Clyde W
Fonarow, Gregg C
Hernandez, Adrian F
Source :
Journal of the American Heart Association, vol 8, iss 24
Publication Year :
2019
Publisher :
eScholarship, University of California, 2019.

Abstract

Background Limited data exist to guide treatment for patients with heart failure with preserved ejection fraction and atrial fibrillation, including the important decision regarding rate versus rhythm control. Methods and Results We analyzed the Get With The Guidelines-Heart Failure (GWTG-HF) registry linked to Medicare claims data from 2008 to 2014 to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation using inverse probability weighted analysis. Rhythm control was defined as use of an antiarrhythmic medication, cardioversion, or AF ablation or surgery. Rate control was defined as use of any combination of β-blocker, calcium channel blocker, and digoxin without evidence of rhythm control. Among 15682 fee-for-service Medicare patients, at the time of discharge, 1857 were treated with rhythm control and 13825 with rate control, with minimal differences in baseline characteristics between groups. There was higher all-cause death at 1year in the rate control compared with the rhythm control group (37.5% and 30.8%, respectively, P

Details

Database :
OpenAIRE
Journal :
Journal of the American Heart Association, vol 8, iss 24
Accession number :
edsair.dedup.wf.001..d3c8b4cb4447b37476a3f50ab7343896