Rhythm verse rate control in patients with atrial fibrillation and heart failure: An updated meta-analysis of randomized controlled trials

Objective:To assess the strategy about rhythm or rate control in patients with atrial fibrillation (AF) and heart failure (HF).Methods:We conducted a systematic search through PUBMED,EMBASE,the Cochrane Library,the Google Scholar database,Wanfang and CNKI for randomized controlled trials (RCT) about rhythm control verse rate control in patients with AF and HF.Quality assessment and data collection were performed by two independent reviewers.Statistical analyses were conducted with Stata 11.0.Results:Eight RCT with 2 170 patients were included in this analysis.Pool dates of all-cause mortality showed no significant difference between rhythm control and rate control (RR:0.97; 95％ CI:O.85-1.10,P =0.638).However,rhythm control could improve LVEF (WMD:8.72; 95％CI:6.70-10.74,P ＜ 0.001) and life quality(WMD:-12.95 ; 95％ CI:-21.09--4.08,P =0.002).Conclusion:The present analysis indicates that rhythm control was associated with the improvement of life quality and their LVEF,but could not reduce all-cause mortality.