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Rate control was more cost effective than rhythm control in persistent atrial fibrillation

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 Q In patients with persistent atrial fibrillation, is rate control more cost effective than rhythm control for reducing cardiovascular morbidity and mortality?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine★★★★★★☆ Cardiology ★★★★★☆☆


Embedded ImageDesign:

cost effectiveness analysis (from a societal perspective) of a randomised controlled trial (RAte Control versus Electrical cardioversion [RACE]).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (outcome assessors and monitoring committee).*

Embedded ImageFollow up period:

mean 2.3 years.

Embedded ImageSetting:

31 centres in the Netherlands.

Embedded ImagePatients:

522 patients who had recurrent persistent atrial fibrillation or flutter, 1–2 electrical cardioversions during the previous 2 years, and no contraindications to oral anticoagulation. Exclusion criteria: arrhythmia lasting >1 year, New York Heart Association class IV heart failure, current or previous treatment with amiodarone, or use of …

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  • * See glossary.

  • For correspondence: Dr I C Van Gelder, University Hospital Groningen, Groningen, The Netherlands.

  • Sources of funding: Center for Health Care Insurance; Interuniversity Cardiology Institute; 3M Pharma.

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