- 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)