Evidence map›Paper›PMID 42809105›Full record

ArticleJMIR research protocols2026

Effects of Rhythm Control versus Rate Control on Atrial Fibrillation and Frailty Development in Older Patients: Protocol for the Cardioversion of Atrial Fibrillation and Frailty in the Elderly (CAFFE) Study, an Observational, Prospective Cohort Study.

Elisa Berni, Veronica De Angelis, Emanuele Santamaria, Alessandro Mengozzi, Claudia Di Serio, Giulia Spanalatte, Michele Biagioli, Arianna Tariello, Marta Niccolini, Camilla Cagnoni and 8 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR research protocols, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

18 authors.

Elisa BerniDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0005-6408-8480
Veronica De AngelisDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID http://orcid.org/0009-0009-0729-1588
Emanuele SantamariaDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0000-2784-7496
Alessandro MengozziDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.ORCID http://orcid.org/0000-0003-2834-9725
Claudia Di SerioDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0000-0002-8570-6111
Giulia SpanalatteDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0008-8072-3677
Michele BiagioliDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0002-6749-8862
Arianna TarielloDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0005-6250-2449
Marta NiccoliniDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0003-9967-1356
Camilla CagnoniDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0006-5340-9979
Djullye Miduri Da Silva NakanoDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0005-3753-8183
Giada Alla ViligiardiDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0004-5578-8330
Marco CapacciDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0009-0005-2770-3608
Andrea UngarDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0000-0002-8965-4523
Giancarlo La MarcaDepartment of Neuroscience and Medical Genetics, Newborn Screening, Clinical Biochemistry and Clinical Pharmacy Laboratory, Meyer Children's Hospital IRCCS, Florence, Department of Experimental and Clinical Biosciences, University of Florence, Florence, Italy.ORCID http://orcid.org/0000-0003-3319-7260
Igor DiembergerDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.ORCID http://orcid.org/0000-0002-3823-3809
Agostino VirdisDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.ORCID http://orcid.org/0000-0002-6994-0223
Stefano FumagalliDepartment of Experimental and Clinical Medicine, University of Florence, Viale Pieraccini, 6, Florence, 50139, Italy, 39 055-2751821.ORCID http://orcid.org/0000-0002-6950-3875

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Atrial fibrillation (AF), highly prevalent in older individuals, is associated with frailty and disability. AF therapy is based on rhythm control (RhythmC) to restore sinus rhythm or rate control (RateC) to lower the heart rate. Published guidelines do not indicate a preference for one over the other for older people. Objective: This study aims to evaluate whether RhythmC is more effective than RateC in hindering the progression of frailty and disability. Methods: The Cardioversion of Atrial Fibrillation and Frailty in the Elderly (CAFFE) study is a prospective, multicenter, observational cohort study that includes 4 groups of patients: (1) adults age 75 years or older undergoing RhythmC treatment; (2) adults aged 65 to 74 years undergoing RhythmC treatment; (3) adults 65 years or older undergoing RateC treatment; and (4) adults 65 years or older without overt chronic conditions as the control group (n=40 in each group). At baseline, all participants will undergo a Comprehensive Geriatric Assessment (CGA) and analyses of inflammation and metabolomics. At home, a device will evaluate each participant's heart rhythm, activity profile, and sleep. After 1 month, the CGA will be repeated. Results: The CAFFE study was funded as a Research Project of National Interest by the Italian Ministry of University and Research (October 2023). Ethical committee final approval was given in June 2024. In October 2025, the coordinating center had enrolled 31 of 40 patients with AF (mean age 78, SD 9 years; 8 [25.8%] women; mean CHA Conclusions: The CAFFE study will evaluate the effectiveness of AF management strategies in older patients. If RhythmC can slow the progression of frailty and disability, specific clinical trials should more definitively address this knowledge gap.

Indexed as

Atrial FibrillationElectric CountershockFrailtyHeart RateAgedAged, 80 and overFemaleGeriatric AssessmentHumansMaleMulticenter Studies as TopicObservational Studies as TopicProspective Studiesatrial fibrillationComprehensive Geriatric Assessmentdisabilityfrailtyolder patientsrhythm-control therapy

Identifiers

PMID42809105
PMCPMC13621886

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.