Comparative occurrence of ischemic stroke with the rhythm versus rate control strategy in a national prospective cohort of atrial fibrillation

Jae Guk Kim, Young Soo Lee, Ki Woon Kang, Eue Keun Choi, Myung Jin Cha, Jung Myung Lee, Jin Bae Kim, Junbeom Park, Jin Kyu Park, Tae Hoon Kim, Jae Sun Uhm, Jaemin Shim, Jun Kim, Hyungwook Park, Changsoo Kim, Boyoung Joung

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background/Aims: Comparative occurrence of ischemic stroke for rhythm versus rate control strategy in patients with non-valvular atrial fibrillation (NVAF) is still inconclusive. The purpose of this study was to investigate whether the rhythm control strategy is associated with a lower risk of ischemic stroke compared to the rate control strategy in NVAF patients. Methods: The CODE-AF registry prospectively enrolled 6,280 consecutive patients who were treated for NVAF at 10 tertiary referral centers in South Korea. Of these, 2,513 NVAF patients (age, 67 ± 10 years; male, 61.8%) were clinically followed up for over 1-year and divided into rate and rhythm control groups. Results: Those treated with the rhythm control strategy were younger and had less proportions of underlying disease compared to those treated with the rate control strategy. After the propensity matching analysis, those treated with the rhythm control strategy had similar baseline characteristics including the CHA2DS2-VASC score compared to those treated with the rate control strategy. The rate of oral anticoagulation, all bleeding, and hospitalization were also simi-larly between the two groups. The incidence rate of ischemic stroke in the rhythm control group was significantly lower than in the rate control group (0.7 vs. 6.9 per 1,000 person-years, p = 0.011). Conclusions: The rhythm control strategy demonstrated a beneficial effect to lower the risk of ischemic stroke during a 1-year follow-up compared to the rate control strategy.

Original languageEnglish
Pages (from-to)114-123
Number of pages10
JournalKorean Journal of Internal Medicine
Volume36
Issue number1
DOIs
Publication statusPublished - 2021 Jan

Bibliographical note

Funding Information:
This research was supported by a grant from the Korean Healthcare Technology R&D project funded by the Ministry of Health and Welfare (HCI15C1200).

Publisher Copyright:
© 2021 The Korean Association of Internal Medicine.

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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