Early rhythm control for AF beneficial for older patients wi
In a prespecified subanalysis of EAST-AFNET 4, researchers analyzed data from 2,789 patients with AF diagnosed within 1 year and concomitant conditions approximating a CHA2DS2-VASc score of at least 2, randomly assigned to systematic early rhythm control therapy (n = 1,395) or usual care (n = 1,394), including delayed, symptom-restricted rhythm control. Patients were stratified by low (< 4; n = 1,696) or high ( 4; n = 1,093) CHA2DS2-VASc score. The primary outcome was a composite of CV death, stroke and hospitalization with worsening HF or ACS.
For patients with a CHA2DS2-VASc score of 4 or greater, early rhythm control was associated with a 36% reduction in risk for the primary outcome, with an HR of 0.64 (95% CI, 0.51-0.81; P < .001). For patients with a CHA2DS2-VASc score of less than 4, early rhythm control did not impact risk for a primary outcome event (HR = 0.93; 95% CI, 0.73-1.19; P = .562; P for interacti

In patients with recently diagnosed atrial fibrillation and a high comorbidity burden, early rhythm control therapy markedly reduced CV death, stroke or hospitalization for HF or ACS.

Source: https://www.healio.com/news/cardiology/20220430/early-rhythm-control-for-af-beneficial-for-older-patients-with-high-comorbidity-burden