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Systematic review and meta-analysis

This trial is included in the following systematic reviews and meta-analyses:

atrial fibrillation - rythm control - all type of patients


Related trials

P-OM3 (Kowey), 2010 - n-3 PUFA vs placebo

Hot cafe, 2004 - electrical cardioversion vs rate control

STAF, 2003 - electrical cardioversion vs rate control

AF-CHF, 2002 - pharmacological cardioversion vs rate control

RACE, 2002 - electrical cardioversion vs rate control

AFFIRM, 2002 - pharmacological cardioversion vs rate control

PIAF, 2000 - pharmacological cardioversion vs rate control



See also:

  • All atrial fibrillation clinical trials
  • All clinical trials of rythm control
  • All clinical trials of pharmacological cardioversion
  •  

    PIAF study, 2000

    download pdf: pharmacological cardioversion | rythm control for atrial fibrillation

    Treatments

    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

    Patients

    Patients patients with with chronic atrial fibrillation
    Baseline characteristics
    Age (yr) 60.5 y 
    Female (%) 27 % 
    heart failure 16.5% 

    Method and design

    Randomized effectives 127 / 125 (studied vs. control)
    Design Parallel groups
    Blinding open
    Follow-up duration 12 months
    Lost to follow-up n=6
    Number of centre multicentre
    Primary endpoint improvement in symptoms


    Results

    Endpoint Studied treat.
    n/N
    Control treat.
    n/N
    Graph RR [95% CI]

    combined endpoint

    4 / 127
    2 / 125
    classic 1,97 [0,37;10,56]

    Major bleeding

    1 / 127
    0 / 125
    classic 4,92 [0,07;358,03]

    All cause death

    2 / 127
    2 / 125
    classic 0,98 [0,14;6,88]

    Hospitalization for any reason

    87 / 127
    30 / 125
    classic 2,85 [2,04;3,98]
    0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial
    Ref
    Studied treat. Control treat.
    Major bleeding 1 / 127 (0,8%) 0 / 125 (0,4%) 1,97 [0,07;58,15]   10160
    combined endpoint 4 / 127 (3,1%) 2 / 125 (1,6%) 1,97 [0,37;10,56]   10160
    All cause death 2 / 127 (1,6%) 2 / 125 (1,6%) 0,98 [0,14;6,88]  
    Hospitalization for any reason 87 / 127 (68,5%) 30 / 125 (24,0%) 2,85 [2,04;3,98]  
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:
  • 10160: Testa L, Biondi-Zoccai GG, Dello Russo A, Bellocci F, Andreotti F, Crea FEur Heart J 2005;26:2000-6

  • Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    combined endpoint 3,15% 1,60% 1,5%
    All cause death 1,57% 1,60% -0,3‰
    Hospitalization for any reason 68,50% 24,00% 44,5%

    Meta-analysis of all similar trials:

    rythm control in atrial fibrillation for all type of patients



    Reference(s)

    Trials register # NA
    • 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
      Pubmed | Hubmed | Fulltext

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