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European Society of Cardiology

Clinical Articles, Lead Article

LANDMARK STUDY ON TREATMENT OPTIONS FOR AF

The first patient has been enrolled, in Hamburg, Germany, for the largest pan-European study to determine whether an early comprehensive rhythm control strategy for the treatment of atrial fibrillation (AF) will benefit patients.

The EAST (Early comprehensive Atrial fibrillation Stroke prevention Trial) clinical trial seeks to determine whether an early, comprehensive, standardised rhythm control therapy can help prevent adverse cardiovascular outcomes associated with atrial fibrillation (AF). More specifically, EAST study will evaluate whether an early and comprehensive rhythm control treatment of patients, to maintain sinus rhythm on top of usual care, leads to better patient outcomes than usual care alone.

Early intervention will include antiarrhythmic drug therapy and/or pulmonary vein isolation (PVI) using catheter ablation as well as ECG monitoring of therapy. Usual care follows standardised therapy under the 2010 ESC guidelines for the treatment of AF.

The primary outcome of EAST is the composite of cardiovascular death, stroke and heart failure or acute coronary syndrome (hospitalisation). There will be outpatient follow-up at 12, 24 and 36 months.

The investigators plan to enroll more than 3,000 patients with recent-onset AF at risk for stroke or death, from 200 centres in 11 European countries.  The trial is a joint venture by the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology, together with the German Competence Network on Atrial Fibrillation (AFNET) and industry partners1.

Prof Dr Paulus Kirchhof, coordinating investigator of the trial said: “The trial is based on the observation that insufficient, non-structured and delayed therapy of the multiple factors that maintain AF and cause its complications has most likely contributed to the limited effectiveness of rhythm control interventions in past trials. This trial takes an important step forward to learn more about the value of rhythm control therapy to improve the lives of AF patients”.

Günter Breithardt (AFNET speaker), Angelo Auricchio, and Panos Vardas (current and past EHRA president) said in a joint statement today: “Investigator-initiated clinical research with a relevant impact requires good ideas, perseverance, a network of colleagues, but also financial resources. As sponsor and co-organiser of the EAST trial, we therefore highly appreciate the financial support from St. Jude Medical and Sanofi-Aventis to make this important clinical research possible”.

References

1 Sanofi and St. Jude Medical have provided grants to support the conduct of the trial.

Published on: September 7, 2011

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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