Abstract 2848: Predictive Factors for Therapeutic Success in Patients With Recent-onset Paroxysmal and Persistent Atrial Fibrillation in the RecordAF Registry
RecordAF is the first worldwide, prospective observational survey of real-life management of patients with recently diagnosed atrial fibrillation (AF). This analysis compares short-term outcomes of rhythm- and rate-control strategies in patients with paroxysmal or persistent AF. A total of 5604 patients with AF (first diagnosis or ≤1 y from diagnosis) were eligible for the study, which took place at 532 sites in 21 countries. Patients entered the survey with the intention to maintain either a rhythm- or rate-control strategy and were followed for 6 months. Therapeutic success (TS) at Month 6 was a composite of control of AF (sinus rhythm for rhythm-control strategy and heart rate ≤80 bpm for rate-control strategy), no strategy cross over, and no major adverse cardiovascular or cerebrovascular events (MACCE) (Table⇓). A multivariate stepwise logistic regression was performed to evaluate factors associated with TS. At Month 6, follow-up information was available for 4893 (87.3%) patients. Of those, 2962 (60.5%) achieved TS, 1838 (67.7%) in the rhythm-control and 1124 (51.6%) in the rate-control strategy. Baseline factors increasing TS were: paroxysmal AF v. persistent AF (OR, 1.838 [95% CI, 1.596 –2.117]), rhythm- v. rate-control strategy (OR, 1.447 [95% CI, 1.264 –1.656]); baseline factors decreasing chances of TS were history of heart failure (OR, NYHA class I/II 0.740 [95% CI, 0.630 – 0.870]; class III/IV 0.672 [95% CI, 0.494 – 0.913]), history of diabetes (OR, 0.766 [95% CI, 0.647– 0.905]), history of arrhythmia other than AF (OR, 0.780 [95% CI, 0.650 – 0.937]), and also higher heart rate (OR, 0.984 [95% CI, 0.980 – 0.987]). After adjustment for propensity score quintiles, rhythm-control strategy remained significantly related to higher TS compared to rate-control strategy (OR, 1.387 [95% CI, 1.203–1.599]). These results suggest that - compared to rate control - rhythm control may improve therapeutic success in patients with paroxysmal or persistent AF.