Abstract TMP93: Comparative Occurrence of Ischemic Stroke with Rhythm versus Rate Control Strategy in a National Prospective Cohort of Atrial Fibrillation

Abstract

Introduction: Comparative occurrence of ischemic stroke for rhythm versus rate control in patients with non-valvular atrial fibrillation (NVAF) has been still inconclusive. The aim of this study was to compare differences of ischemic stroke occurrence between the rhythm and rate control strategies in AF patients. Methods: The CODE-AF registry prospectively enrolled 6,280 consecutive patients who were treated for NVAF at 10 tertiary referral centers in South Korea. Of these, 2,513 (40.0%) NVAF patients (age, 67±10 years; male, 61.8%) were clinically followed up for 1-year and divided into rate control 1,233 (49.0%) and rhythm control 1280 (51.0%) group. Results: Those treated with the rhythm control group were younger, and had less proportions of underlying disease compared to those treated with the rate control strategy. After propensity score matching analysis, 1,800 of these patients was compared and analyzed between rate control and rhythm control group. Those treated with the rhythm control group were similar in the baseline characteristics including CHA 2 DS 2 -VASC score compared to those treated with the rate control strategy. The rate of oral anticoagulation, all bleeding, and hospitalization were also similarly between two groups. The incidence rate of ischemic stroke in the rhythm control group was significantly lower than rate control group (0.7 vs. 6.9 per 1000 person-years, p=0.011). Conclusion: In this national prospective AF cohort, the rhythm control strategy demonstrated beneficial effect to lower the risk of ischemic stroke during 1-year follow-up compared to rate control strategy.