by a cardiologist. The control arm (n ¼ 356) consisted of patients who remained under the usual care by a cardiologist. After a followup of almost 2 years, cardiovascular hospitalizations or cardiovascular death occurred in 14% of the patients in the nurse-led care arm and 21% in the usual care arm. The cardiovascular death rate was reducedby70%andthehospitalizationrateby35%,bothstatistically and clinically significant. InthisissueoftheJournal,Hendriksetal. 21 publishedtheresultsof the cost-effectiveness analysis from this trial. A total of 645 patients, 323inthenurse-ledcaregroupand322intheusualcaregroup,were included, and a cost per life-year and a cost per quality-adjusted lifeyear(QALY)analyseswereperformed.Thecostsfordiagnosticprocedures, outpatient care, medication therapy, interventional procedures, inpatient care, and the use of software were considered. The mean total healthcare cost per patient (hospitalizations included), was not statistically different between the nurse-led care (mean E2.302) and the usual care (mean E3.037). The quality of life scores (using the Short Form 36 questionnaire) were converted into utility scores, and then QALYs were calculated by multiplying the utility score by the time the patient was experiencing that utility. The mean QALYs were also not statistically different between the two groups (0.603 in the nurse-led care arm vs. 0.594 intheusualcare).Whenperformingcost-effectivenessanalyses,considering costs and beneficial effects, nurse-led care was superior to usual care.Costs for nurse-led carewere lower, whereasthe clinical results were better. Based on present analysis, the nurse-led integrated chronic care programme for patients with AF seems a costeffective approach. The authors should be congratulated on their interesting findings; however,therearesomelimitationsthatneedtobeconsidered.First, thisrandomizedcontrolledtrialisperformedinasingle,highlyspecialized AF centre, with well-trained nurses. Whether the results are generalizable to other less specialized cardiology practices or even in general physician practices needs to be determined. Currently, the integRAted chronic care programme at a specialized AF clinic vs. usual CarE in patients with AF, a multicentre randomized