Does intensity of rate-control influence outcome in atrial fibrillation? An analysis of pooled data from the RACE and AFFIRM studies

Aims The AFFIRM and RACE studies showed that rate control is an acceptable treatment strategy for atrial, fibrillation (AF). We examined whether strict rate control offers benefit over more lenient rate control.Methods and Results We compared the outcome of patients enrolled in the rate-control arms of AFFIRM and RACE, using data from patients who met a composite of overlapping inclusion and exclusion criteria. We evaluated 1091 patients, 874 from AFFIRM and 217 from RACE. In AFFIRM, the rate-control strategy aimed for a resting heart rate = 100 (hazard ratios 0.69 and 0.58, respectively, for = 100 bpm).Conclusion Stringency of the approach to rate control, based on the comparison of the AFFIRM and RACE studies, was not associated with an important difference in clinical events.