Rhythm Control Best for Afib?
Older patients with atrial fibrillation (irregular heartbeat) had a higher rate of survival after 5 years when they were treated with rhythm control drugs rather than rate control drugs. That was a key finding of a study of patients 66 and over led by Louise Pilote, MD, MPH, PhD, of Royal Victoria Hospital in Montreal and published online in the Archives of Internal Medicine.
The catch is that this was an observational study, meaning that the research only draws inferences about the possible effect of the treatment but does not prove cause and effect. Previous randomized clinical trials – the preferred design for scientific experiments – did not show increased benefits for rhythm control as opposed to rate control. However, the clinical trials were shorter than 5 years. According to MedPage Today, the authors of editorials accompanying the Pilote article speculated that "the longer maximum follow-up in the current study may have been sufficient to observe the emergence of a rhythm control benefit."
The editorialists also noted that "the ongoing randomized CABANA (Catheter Ablation versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation) trial likely will provide data to help clarify this debate." So stay tuned! We at ThirdAge will bring you those results when they become available.