atrial fibrillation and stroke prevention - Continuing Medical ...

Essentials in Primary Care Conference
Wednesday, July 31, 2013
RACE-II Trial
• Primary outcome (composite of death from
CV causes, hospitalization for heart failure,
stroke, systemic embolism, bleeding, lifethreatening
arrhythmias)
–12.9% lenient control vs 14.9% strict (NS)
• No difference in any individual outcome
• No difference in hospitalizations or adverse
effects
• Conclusion: lenient rate control (resting HR
< 110) is as effective and easier to achieve
Van Gelder IC, et al. RACE II trial. NEJM 2010;362:1363-73.
2011 ACCF/AHA/HRS Focused Update:
Strict vs Lenient Control
• Class III-No Benefit
- Treatment to achieve strict rate control (HR < 80
bpm at rest or < 110 bpm during 6-min walk) is not
beneficial compared to achieving a resting HR <
110 bpm in patients with persistent AF who have
stable ventricular function and no or acceptable
symptoms related to the arrhythmia
Wann LS et al. Circulation 2011;123:11144-1150.
Jan Basile, MD
Atrial Fibrillation & Stroke Prevention