Evidence map›Paper›PMID 31745834›Full record

SynthesisDrugs & aging2020

Clinical Outcomes of Rate vs Rhythm Control for Atrial Fibrillation in Older People: A Systematic Review and Meta-Analysis.

Laurence Depoorter, Liza Sels, Mieke Deschodt, Bastiaan Van Grootven, Lorenz Van der Linden, Jos Tournoy

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 22 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
  5. Article
  6. ANMCO-SIMEU consensus document: appropriate management of atrial fibrillation in the emergency department.European heart journal supplements : journal of the European Society of Cardiology · 2023
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Laurence DepoorterGeriatric Department, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.ORCID 0000-0003-3418-8884
Liza SelsGeriatric Department, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Mieke DeschodtGerontology and Geriatrics, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven-University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Bastiaan Van GrootvenResearch Foundation Flanders, Brussels, Belgium.
Lorenz Van der LindenPharmacy Department, University Hospitals Leuven, Leuven, Belgium.
Jos TournoyGeriatric Department, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. Jos.tournoy@uzleuven.be.
KU Leuven · BEResearch Foundation - Flanders · BEUniversity of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesAtrial fibrillation (AF) is highly prevalent in older adults and has been associated with increased morbidity and mortality. To reduce this AF-related morbidity in older adults, antiarrhythmic drugs (AADs) are regularly used for rhythm control, assuming that increasing time in sinus rhythm reduces AF-related morbidity. However, whether AADs can improve clinical outcomes in older adults remains unclear because of the increased risk for adverse drug events compared with rate control. The aim of this study was to determine the impact of rhythm control versus rate control on clinical outcomes in older adults with AF. DESIGN AND

methodsWe conducted a systematic review and meta-analysis targeting patients aged ≥65 years with AF and using drugs to control rate or rhythm. Articles that met the following criteria were included: enrolled older patients (sample mean ≥75 years) with AF, compared pharmacological rate versus rhythm control, and reported all-cause mortality, cardiovascular mortality, or ischemic stroke.

resultsFive observational studies were included. In total, 86,926 patients with AF with a mean age ranging from 75 to 92 years were studied. No differences were found between rhythm and rate control for all-cause mortality (odds ratio [OR] 1.11; 95% confidence interval [CI] 0.78-1.59; I

conclusionAll collected data were observational, which precluded making strong recommendations. Furthermore, all CIs were wide, increasing the uncertainty of the observed effects. As such, evidence was insufficient to recommend rhythm or rate control as the first-line therapy for AF in older adults. As AF is particularly prevalent in older people, more randomized controlled trials are needed in this population.

Indexed as

AgedAged, 80 and overAnti-Arrhythmia AgentsAtrial FibrillationBlood PressureFemaleHeart RateHumansMaleMiddle AgedObservational Studies as TopicOdds RatioStrokeAnti-Arrhythmia Agents

Identifiers

PMID31745834
OpenAlexW2991392412

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.