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Clinical Impact of Early Rhythm Control and Healthy Lifestyles in Patients with Atrial Fibrillation (JCEP June 2024)
Clinical Impact of Early Rhythm Control and Healthy Lifestyles in Patients with Atrial Fibrillation


Background: There are limited data regarding the combined effect of early rhythm control (ERC) and healthy lifestyles (HLS) on the risk of ischemic stroke in patients with atrial fibrillation (AF).


Objectives: To evaluate how the combination of ERC and HLS impacts on the risk of ischemic stroke in patients with AF.


Methods: Using the Korean National Health Insurance database, we included patients with new-onset AF between 2009 and 2016 (n=208,662). Patients who received rhythm control therapy within 2-year after AF diagnosis were defined as the ERC group. Patients with ≥2 HLS were defined as the HLS group. Patients were categorized into 4 groups: group 1 without ERC and HLS (n=46,972), group 2 with HLS alone (n=110,479), group 3 with ERC alone (n=15,133) and group 4 with both ERC and HLS (n=36,078). The primary outcome was ischemic stroke.


Results: Compared to group 1, group 2 and group 3 were associated with a lower risk of stroke (HR, 95% confidence interval: 0.769, 0.728-0.881, and 0.774, 0.703-0.852, respectively). Group 4 showed the lowest risk of stroke (0.575, 0.536-0.617). After propensity score weighting, the incorporation of additional ERC alongside HLS was associated with a relative risk reduction of 22% for stroke, while additional HLS alongside ERC was associated with a relative risk reduction of 27% for stroke.

 

Conclusion: Each of ERC and HLS might reduce the risk of ischemic stroke in patients with new-onset AF. The presence of both ERC and HLS is associated with an enhanced benefit for stroke prevention in this population.

 

Editor-in-Chief
Kalyanam Shivkumar, MD, PhD, FACC
 
CME Editor
Kenneth A. Ellenbogen, MD, FACC

Author
Kelvin Bush, MD, FACC

Important Dates

Date of Release: June 24, 2024
Term of Approval/Date of CME/MOC Expiration: June 23, 2025

 

Summary
Availability: On-Demand
Expires on Jun 23, 2025
Cost: FREE
Credit Offered:
1 CME Credit
1 ABIM-MOC Point
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