EAST-AFNET 4
Early Treatment of Atrial Fibrillation for Stroke Prevention Trial
Patient / Population Intervention / Exposure Comparison Outcome
In 2,789 patients with early AF (≤ 1 yr), early rhythm-control therapy reduced CV death, stroke or hospitalisation for HF or ACS versus usual care.
N
2,789
Design
Open-label, blinded endpoint, median 5.1 yr
Endpoint
Composite CV death, stroke, HF/ACS hosp
Relevance
2
Result3.9 vs 5.0 per 100 patient-years (HR 0.79).
Kirchhof P, et al. N Engl J Med. 2020;383(14):1305-1316. 10.1056/NEJMoa2019422
Discussion & critique
Reopened the rhythm-vs-rate question — but only for AF diagnosed in the last year. ~ 8 % had ablation by 2 yr; mostly drug-based.