Routine Versus Aggressive Upstream Rhythm Control for Prevention of Early Atrial Fibrillation in Heart Failure (RACE 3)

I.C. Van Gelder

Status

Completed

Conditions

Atrial Fibrillation

Treatments

Other: Upstream therapy

Other: Conventional rhythm control

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT00877643

NHS B 2008 035

Details and patient eligibility

About

The purpose of this study is to investigate whether in patients with early persistent atrial fibrillation and mild to moderate early heart failure an aggressive upstream rhythm control approach, including aldosterone receptor antagonists and statins, dietary restrictions, counseling and cardiac rehabilitation programs, increases persistence of sinus rhythm compared with conventional rhythm control after one year of follow-up.

A randomized long term extension of the RACE 3 will be performed with a total follow-up of 5 years to investigate the long term effects on persistence of sinus rhythm and cardiovascular morbidity and mortality of the two treatment strategies.

Enrollment

250 patients

Sex

All

Ages

40+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Early symptomatic persistent atrial fibrillation
Mild to moderate early heart failure
Optimal documentation and treatment of underlying heart disease
No contra-indication for oral anticoagulation
Eligible for cardiovascular rehabilitation
Age >= 40 years

Exclusion criteria

On waiting list for pulmonary vein isolation or expected to be placed on waiting list within one year
Heart failure NYHA class IV
LVEF < 25%
Left atrial size > 50 mm (parasternal axis)
Present aldosterone receptor antagonist use
Previous use of class I or III antiarrhythmic drugs (except for sotalol, which should be discontinued at inclusion and replaced with betablocker)
Cardiac resynchronization therapy