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Atrial fibrillation (AF) represents a large and growing burden on cardiovascular healthcare and leads to a substantial impact on quality-of-life, increased cardiovascular events and a doubling of hospitalisation and death rates.1 Unlike many other cardiac conditions, the evidence base for treatment in AF remains patchy with clear gaps relating to a number of clinically important management strategies. Current practice involves three major elements: anticoagulation to prevent stroke or systemic embolism, medications to control heart rate and a decision on whether to restore and maintain sinus rhythm. This systematic review and meta-analysis of tabular data addresses the benefits and risks of adding rhythm control to rate control therapy, considers the preferential method …
Competing interests DK is the Steering Committee Lead for the β-blockers in Heart Failure Collaborative Group: Individual Patient Data Meta-Analysis.8 PK is a Board member of AFNET, an academic research organisation running trials in atrial fibrillation, and a recipient of research grants from the British Heart Foundation, DFG, Fondation Leducq, the European Union and others. He is also the principal investigator of the investigator-initiated EAST trial.6 A full list of financial disclosures is available on the website of the ESC.
Provenance and peer review Commissioned; internally peer reviewed.