Chest
Clinical InvestigationsCARDIOLOGYRate Control vs Rhythm Control in Patients With Nonvalvular Persistent Atrial Fibrillation: The Results of the Polish How to Treat Chronic Atrial Fibrillation (HOT CAFE) Study
Section snippets
Materials and Methods
The HOT CAFE study12 was a prospective, randomized, open multicenter clinical trial that was designed to evaluate the effects of rhythm control vs rate control in patients with persistent AF. The study involved six cardiology centers in central Poland, five of which enrolled patients. The study was approved by the institutional review board or ethics committee at those centers, and consecutive, eligible patients provided written informed consent. Recruitment began in March 1997, randomization
Baseline Characteristics
Of 738 screened patients with AF from March 1997 to December 2000, 205 patients (134 men and 71 women) met the inclusion criteria and were enrolled into the study. Valvular heart disease (21%), thyrotoxicosis (13%), and advanced stages of concomitant diseases influencing the natural history of AF (11%) were the main exclusion criteria limiting enrollment. One hundred one consecutive patients were randomly assigned to the heart rate control group. The restoration and maintenance of sinus rhythm
Discussion
The results of the HOT CAFE study have provided data that are relevant to the management of patients with AF. Our study demonstrated that the rate control of AF is as acceptable as sinus rhythm restoration and maintenance. Despite the relatively small number of enrolled patients and the short observation period, our study suggests that, at least with currently available pharmacologic therapy, there is no distinct advantage associated with the rhythm control strategy. Moreover, the control of
Conclusions
The HOT CAFE study suggests that the rate control of persistent AF is equivalent to rhythm control in terms of mortality rate, stroke, and thromboembolic and severe bleeding complications. Therefore, our trial supports the results of other studies, although our population was younger and possibly had AF relatively longer than other populations (for up to 2 years). The HOT CAFE trial, like the PIAF, AFFIRM, RACE, and other trials, showed no significant differences in the two proposed treatment
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Cited by (0)
The study results were presented at the 24th Congress of the European Society of Cardiology, Berlin, Germany, in October 2002.
The study was supported by Polish Government research grant No. PO5B06012.