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Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial

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Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial. / Metzner, Andreas; Suling, Anna; Brandes, Axel; Breithardt, Günter; Camm, A John; Crijns, Harry J G M; Eckardt, Lars; Elvan, Arif; Goette, Andreas; Haegeli, Laurent M; Heidbuchel, Hein; Kautzner, Josef; Kuck, Karl-Heinz; Mont, Luis; Ng, A Andre; Szumowski, Lukasz; Themistoclakis, Sakis; van Gelder, Isabelle C; Vardas, Panos; Wegscheider, Karl; Willems, Stephan; Kirchhof, Paulus.

In: EUROPACE, Vol. 24, No. 4, 05.04.2022, p. 552-564.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Metzner, A, Suling, A, Brandes, A, Breithardt, G, Camm, AJ, Crijns, HJGM, Eckardt, L, Elvan, A, Goette, A, Haegeli, LM, Heidbuchel, H, Kautzner, J, Kuck, K-H, Mont, L, Ng, AA, Szumowski, L, Themistoclakis, S, van Gelder, IC, Vardas, P, Wegscheider, K, Willems, S & Kirchhof, P 2022, 'Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial', EUROPACE, vol. 24, no. 4, pp. 552-564. https://doi.org/10.1093/europace/euab200

APA

Metzner, A., Suling, A., Brandes, A., Breithardt, G., Camm, A. J., Crijns, H. J. G. M., Eckardt, L., Elvan, A., Goette, A., Haegeli, L. M., Heidbuchel, H., Kautzner, J., Kuck, K-H., Mont, L., Ng, A. A., Szumowski, L., Themistoclakis, S., van Gelder, I. C., Vardas, P., ... Kirchhof, P. (2022). Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial. EUROPACE, 24(4), 552-564. https://doi.org/10.1093/europace/euab200

Vancouver

Metzner A, Suling A, Brandes A, Breithardt G, Camm AJ, Crijns HJGM et al. Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial. EUROPACE. 2022 Apr 5;24(4):552-564. https://doi.org/10.1093/europace/euab200

Bibtex

@article{8d31865cd4c14572a3b8ad0a698c584f,
title = "Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial",
abstract = "AIMS: Treatment patterns were compared between randomized groups in EAST-AFNET 4 to assess whether differences in anticoagulation, therapy of concomitant diseases, or intensity of care can explain the clinical benefit achieved with early rhythm control in EAST-AFNET 4.METHODS AND RESULTS: Cardiovascular treatment patterns and number of visits were compared between randomized groups in EAST-AFNET 4. Oral anticoagulation was used in >90% of patients during follow-up without differences between randomized groups. There were no differences in treatment of concomitant conditions between groups. The type of rhythm control varied by country and centre. Over time, antiarrhythmic drugs were given to 1171/1395 (84%) patients in early therapy, and to 202/1394 (14%) in usual care. Atrial fibrillation (AF) ablation was performed in 340/1395 (24%) patients randomized to early therapy, and in 168/1394 (12%) patients randomized to usual care. 97% of rhythm control therapies were within class I and class III recommendations of AF guidelines. Patients randomized to early therapy transmitted 297 166 telemetric electrocardiograms (ECGs) to a core lab. In total, 97 978 abnormal ECGs were sent to study sites. The resulting difference between study visits was low (0.06 visits/patient/year), with slightly more visits in early therapy (usual care 0.39 visits/patient/year; early rhythm control 0.45 visits/patient/year, P < 0.001), mainly due to visits for symptomatic AF recurrences or recurrent AF on telemetric ECGs.CONCLUSION: The clinical benefit of early, systematic rhythm control therapy was achieved using variable treatment patterns of antiarrhythmic drugs and AF ablation, applied within guideline recommendations.",
author = "Andreas Metzner and Anna Suling and Axel Brandes and G{\"u}nter Breithardt and Camm, {A John} and Crijns, {Harry J G M} and Lars Eckardt and Arif Elvan and Andreas Goette and Haegeli, {Laurent M} and Hein Heidbuchel and Josef Kautzner and Karl-Heinz Kuck and Luis Mont and Ng, {A Andre} and Lukasz Szumowski and Sakis Themistoclakis and {van Gelder}, {Isabelle C} and Panos Vardas and Karl Wegscheider and Stephan Willems and Paulus Kirchhof",
note = "{\textcopyright} The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2022",
month = apr,
day = "5",
doi = "10.1093/europace/euab200",
language = "English",
volume = "24",
pages = "552--564",
journal = "EUROPACE",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "4",

}

RIS

TY - JOUR

T1 - Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial

AU - Metzner, Andreas

AU - Suling, Anna

AU - Brandes, Axel

AU - Breithardt, Günter

AU - Camm, A John

AU - Crijns, Harry J G M

AU - Eckardt, Lars

AU - Elvan, Arif

AU - Goette, Andreas

AU - Haegeli, Laurent M

AU - Heidbuchel, Hein

AU - Kautzner, Josef

AU - Kuck, Karl-Heinz

AU - Mont, Luis

AU - Ng, A Andre

AU - Szumowski, Lukasz

AU - Themistoclakis, Sakis

AU - van Gelder, Isabelle C

AU - Vardas, Panos

AU - Wegscheider, Karl

AU - Willems, Stephan

AU - Kirchhof, Paulus

N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2022/4/5

Y1 - 2022/4/5

N2 - AIMS: Treatment patterns were compared between randomized groups in EAST-AFNET 4 to assess whether differences in anticoagulation, therapy of concomitant diseases, or intensity of care can explain the clinical benefit achieved with early rhythm control in EAST-AFNET 4.METHODS AND RESULTS: Cardiovascular treatment patterns and number of visits were compared between randomized groups in EAST-AFNET 4. Oral anticoagulation was used in >90% of patients during follow-up without differences between randomized groups. There were no differences in treatment of concomitant conditions between groups. The type of rhythm control varied by country and centre. Over time, antiarrhythmic drugs were given to 1171/1395 (84%) patients in early therapy, and to 202/1394 (14%) in usual care. Atrial fibrillation (AF) ablation was performed in 340/1395 (24%) patients randomized to early therapy, and in 168/1394 (12%) patients randomized to usual care. 97% of rhythm control therapies were within class I and class III recommendations of AF guidelines. Patients randomized to early therapy transmitted 297 166 telemetric electrocardiograms (ECGs) to a core lab. In total, 97 978 abnormal ECGs were sent to study sites. The resulting difference between study visits was low (0.06 visits/patient/year), with slightly more visits in early therapy (usual care 0.39 visits/patient/year; early rhythm control 0.45 visits/patient/year, P < 0.001), mainly due to visits for symptomatic AF recurrences or recurrent AF on telemetric ECGs.CONCLUSION: The clinical benefit of early, systematic rhythm control therapy was achieved using variable treatment patterns of antiarrhythmic drugs and AF ablation, applied within guideline recommendations.

AB - AIMS: Treatment patterns were compared between randomized groups in EAST-AFNET 4 to assess whether differences in anticoagulation, therapy of concomitant diseases, or intensity of care can explain the clinical benefit achieved with early rhythm control in EAST-AFNET 4.METHODS AND RESULTS: Cardiovascular treatment patterns and number of visits were compared between randomized groups in EAST-AFNET 4. Oral anticoagulation was used in >90% of patients during follow-up without differences between randomized groups. There were no differences in treatment of concomitant conditions between groups. The type of rhythm control varied by country and centre. Over time, antiarrhythmic drugs were given to 1171/1395 (84%) patients in early therapy, and to 202/1394 (14%) in usual care. Atrial fibrillation (AF) ablation was performed in 340/1395 (24%) patients randomized to early therapy, and in 168/1394 (12%) patients randomized to usual care. 97% of rhythm control therapies were within class I and class III recommendations of AF guidelines. Patients randomized to early therapy transmitted 297 166 telemetric electrocardiograms (ECGs) to a core lab. In total, 97 978 abnormal ECGs were sent to study sites. The resulting difference between study visits was low (0.06 visits/patient/year), with slightly more visits in early therapy (usual care 0.39 visits/patient/year; early rhythm control 0.45 visits/patient/year, P < 0.001), mainly due to visits for symptomatic AF recurrences or recurrent AF on telemetric ECGs.CONCLUSION: The clinical benefit of early, systematic rhythm control therapy was achieved using variable treatment patterns of antiarrhythmic drugs and AF ablation, applied within guideline recommendations.

U2 - 10.1093/europace/euab200

DO - 10.1093/europace/euab200

M3 - SCORING: Journal article

C2 - 34473249

VL - 24

SP - 552

EP - 564

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 4

ER -