Study designs of evaluations included in the review
Randomised controlled trials (RCTs) with 200 or more participants were eligible for inclusion.
Specific interventions included in the review
Studies comparing rhythm control strategies with rate control strategies were eligible for inclusion.
Participants included in the review
Studies of people with spontaneously occurring AF were sought. The participants in the included studies had persistent or recurrent AF. Between 59 and 74% were men and the mean ages ranged from 60 to 70 years. The rhythm control treatments included electrical cardioversion, amiodarone, dispyramide, flecainide, morcizine, procainamide, propafenone, quinidine, sotalol, dofetilide, class 1 anti-arrhythmics, or combinations of these. The rate control treatments involved the use of verapamil, diltiazem, beta-blockers, digitalis, amiodarone or AV node ablation and pacemaker, or combinations of these. In addition, oral anticoagulation was mandatory or encouraged.
Outcomes assessed in the review
The outcomes of interest were all-cause death, hospitalisation, non-central nervous system (CNS) bleeding and ischaemic stroke. Reported adverse effects and quality-of-life scores (using the Medical Outcomes short-form health survey, SF-36) were also assessed.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.