In this trial of 614 patients with chronic afib, they were randomized to strict (<80 beats per minute at rest, <110 with exercise) or lenient control (<110 anytime). The primary composite outcome (CV death, CHF hospitalization, life threatening arrythmia, stroke, systemic embolism, bleeding) occurred in 13% of the lenient and 15% of the strict control (making lenient control non-inferior). Target heart rate was achieved in 98% of lenient and only 67% of strict control patients, and the lenient control patients had significantly fewer visits. Lenient control of afib is clinically equivalent and easier to attain (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.