Study highlights some best practices in the treatment of AF patients

June 3, 2014 – Sana Al-Khatib, MD, MHS leads study that was published today in the Annals of Internal Medicine.

A recent DCRI-led study provides new insights into the comparative safety and effectiveness of different therapies to control ventricular heart rate (HR) and heart rhythm in patients with atrial fibrillation (AF). The results shine new light onto a major health problem, which is responsible for nearly $16 billion in costs to the United States’ health care system per year.

sana-al-khatib-archive2The research, which explored data from 162 studies involving more than 28,000 patients, shows that (1) in older AF patients with mild symptoms, using medications to control HR or heart rhythm had a similar effect on death due to all causes, heart disease, and stroke; (2) there have been few studies that compare different drugs to control HR or heart rhythm, and also few studies that report on the outcomes of interest; (3) in younger patients who do not have substantial structural heart disease that is causing their AF, pulmonary vein isolation (PVI), which is a procedure performed to regulate HR, is more effective than using medication to reduce AF recurrence; and (4) performing a “MAZE” surgical procedure at the time of other heart surgery is more effective at reducing AF recurrence than performing heart surgery alone.

The study results were published today in the Annals of Internal Medicine. The lead author for this study was Sana Al-Khatib, MD, MHS, who also received contributions from DCRI and Duke colleagues, including Nancy Allen LaPointe, PharmD, MHS; Ranee Chatterjee, MD, MPH; Matthew Crowley, MD; Matthew Dupre, PhD; David Kong, MD; Renato Lopes, MD, PhD; Thomas Povsic, MD, PhD; Shveta Raju, MD; Bimal Shah, MD; Andrzej Kosinski, PhD; Amanda McBroom, PhD; and Gillian Sanders, PhD.

This review also highlights areas where future research is needed for clinical decision-making in the treatment of AF. New research should focus on the effectiveness, tolerability, and safety of different antiarrhythmic medications, HR-controlling procedures, and many other surgical and therapy options.