Making sense out of non sense : Three cheers to “care free” rate control in atrial fibrillation !
Posted Mar 15 2010 10:57am
Management of atrial fibrillation has been a big puzzle for cardiologists for many decades till it became a corporate game , and now in the era of recession it has become medicare’s night mare !
So , we were made to dance to the tunes of the so called evidence based cardiology . . .
From only rhythm control to . . . in 1990s
Either rhythm or rate control . . . in early late 1990s
Then cost control was found more important than rate control . . .
. . . So rate control became superior to rhythm control in early 2000s
In 2010 , even the rate control became a luxury , here comes the real ace ! ” Casual rate control may be suffice in most cases of AF “
Read this article from NEJM , which tries to make sense out of nonsense and judge for yourself
Probably the most influential article in electrophysiology over the next decade
Click below to reach Nejm article
Gist of the trial
Technically and literally it means a “Take it easy attitude” as long as patient is comfortable , even a rate of more than 100 is allowed . Few years back the above concept could be termed a “non sense”
In this perennial management issue of AF , Whether , we were successful in restoring sinus rhythm or not , we have restored the common sense* Thanks to RACE 2 investigators.
* Do not unnecessarily trouble a asymptomatic patient with those powerful and costly antiarrhythmic drugs .