- 著者
- 
             
             Satoshi Ogawa
             
             Takeshi Yamashita
             
             Tsutomu Yamazaki
             
             Yoshifusa Aizawa
             
             Hirotsugu Atarashi
             
             Hiroshi Inoue
             
             Tohru Ohe
             
             Hiroshi Ohtsu
             
             Ken Okumura
             
             Takao Katoh
             
             Shiro Kamakura
             
             Koichiro Kumagai
             
             Yoshihisa Kurachi
             
             Itsuo Kodama
             
             Yukihiro Koretsune
             
             Tetsunori Saikawa
             
             Masayuki Sakurai
             
             Kaoru Sugi
             
             Toshifumi Tabuchi
             
             Haruaki Nakaya
             
             Toshio Nakayama
             
             Makoto Hirai
             
             Masahiko Fukatani
             
             Hideo Mitamura
             
             for the J-RHYTHM Investigators
             
          
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.73, no.2, pp.242-248, 2009 (Released:2009-01-23)
- 参考文献数
- 31
- 被引用文献数
- 
             
             85
             
             
             161
             
             
          
        
        Background Although previous clinical trials demonstrated the non-inferiority of a rate control to rhythm control strategy for management of atrial fibrillation (AF), the optimal treatment strategy for paroxysmal AF (PAF) remains unclear. Methods and Results A randomized, multicenter comparison of rate control vs rhythm control in Japanese patients with PAF (the Japanese Rhythm Management Trial for Atrial Fibrillation (J-RHYTHM) study) was conducted. The primary endpoint was a composite of total mortality, symptomatic cerebral infarction, systemic embolism, major bleeding, hospitalization for heart failure, or physical/psychological disability requiring alteration of treatment strategy. In the study, 823 patients with PAF were followed for a mean period of 578 days. The primary endpoint occurred in 64 patients (15.3%) assigned to rhythm control and in 89 patients (22.0%) to rate control (P=0.0128). No significant differences between the treatment strategies were observed in the incidences of death, stroke, bleeding and heart failure. Meanwhile, significantly fewer patients requested changes of assigned treatment strategy in the rhythm control vs the rate control group, which was accompanied by improvement in AF-specific quality of life scores. Conclusion The J-RHYTHM study showed that rhythm control was associated with fewer primary endpoints than rate control. However, mortality and cardiovascular morbidity were not affected by the treatment strategy (umin-CTR No. C000000106). (Circ J 2009; 73: 242 - 248)