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).
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