Acronym: Atrial Fibrillation-Congestive Heart Failure trial
Purpose: Evaluate the impact of beta-blockers on hospitalization and mortality in patients with atrial fibrillation and congestive HF.
Format: Randomized, open-label, parallel assignment
Study Group 1: Beta-blockers at baseline
Study Group 2: No beta-blockers at baseline
Number of Patients: 1,376
- Left ventricular ejection fraction (LVEF) ≤35% with symptomatic congestive heart failure OR a LVEF <25%
- One electrocardiographically documented episode of AF that lasted >6 h OR required cardioversion in the preceding 6 months, OR an episode of AF that lasted >10 min in the preceding 6 months combined with cardioversion for AF at any time
- AF that persisted for >12 months qualified if sinus rhythm could be maintained for >24 h following cardioversion
Primary Endpoint: all-cause mortality
- cardiovascular mortality
- all-cause hospitalizations
- cardiovascular hospitalizations
- hospitalizations for worsening heart failure
Follow-up: Median 37 months
Beta-blockers were associated with lower all-cause mortality but did not impact hospitalizations. In sensitivity analyses using beta-blockers as a time-dependent variable, the results were similar. There were no interactions for either outcome between beta-blockers and burden of AF or pattern of AF.
Cadrin-Tourigny J, et al. JACC Heart Fail. 2017;doi:10.1016/j.jchf.2016.10.015.