Interv Akut Kardiol. 2023;22(2):91-94 | DOI: 10.36290/kar.2023.013

What has the EAST-AFNET 4 trial and its sub-analyses found?

Petr Peichl, Josef Kautzner

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

The EAST-AFNET 4 trial has brought a major paradigm shift in the treatment of atrial fibrillation (AF). The results of the trial have confirmed the findings of previous observational studies that have demonstrated that in patients with recently diagnosed AF, early rhythm control improves prognosis compared to usual care (mostly aimed at rate control). The sub-analyses have shown that the observed benefit is dependent on the presence of sinus rhythm. Thus, in patients with recently diagnosed AF, the treatment should aim at restoration and maintenance of sinus rhythm. This applies to patients with both paroxysmal and persistent AF regardless of the presence of AF symptoms or heart failure. It is conceivable that the next guidelines from the European Society of Cardiology will no longer be focused on the treatment of symptomatic AF, but rather support rhythm control strategy for most patients with this arrhythmia.

Keywords: atrial fibrillation, stroke, antiarrhythmic drugs, catheter ablation, heart failure.

Received: April 5, 2023; Accepted: April 19, 2023; Published: May 9, 2023  Show citation