PIAF, 2000 trial summary    PDF trial summary

A randomised clinical trial investigating the effect of pharmacological cardioversion versus rate control in patients with with chronic atrial fibrillation

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Lancet 2000;356:1789-94  



Studied treatment rhythm control - amiodarone (600mg for 3 weeks, 200mg maintenance) for pharmacological cardioversion followed if necessary by electrical cardioversion
Control treatment rate control - diltiazem90mg BD/TDS and additional therapy at the discretion of the treating physicianall patients were anticoagulated throughout the study period
Age (yr) 60.5 y
Female (%) 27 %



Patients patients with with chronic atrial fibrillation
Group sizes127 / 125
heart failure 16.5%
Use of cement
Duration of permanent atrial fibrillation
Duration of any atrial fibrillation
CHADS2 score 3-6
CHADS2 score 2
CHADS2 score 0-1
Heart rate at rest
Left ventricular ejection fraction



Blindness open Inclusion period
Follow-up duration 12 months Centers multicentre
Lost to FU n=6 geographical localisation
Primary endpoint improvement in symptoms Design Parallel groups



EndpointX1N1X0N0TE95% CI combined endpoint 4 127 2 125 1,97[0,35; 10,95] major bleedings 1 127 0 125 Out of scale2,95[0,12; 73,19] CV death - 127 - 125 no data death by cardiac arrhythmia - 127 - 125 no data hospitalisations (excluding those for cardioversion) 87 127 30 125 Out of scale2,82[1,62; 4,92] death 2 127 2 125 0,98[0,17; 5,78] stroke/TIA - 127 - 125 no data Peripheral embolism - 127 - 125 no data Atrial fibrillation follow-up - 127 - 125 no data0,22,01,0

Hohnloser SH, Kuck KH, Lilienthal J Rhythm or rate control in atrial fibrillation--Pharmacological Intervention in Atrial Fibrillation (PIAF): a randomised trial. Lancet 2000;356:1789-94     [PMID: 11117910]   link to pdf   add to Mendeley  



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