AFFIRM Trial: A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation Multicenter, parallel-group, randomized, controlled trial Objective: Among patients with atrial fibrillation and a high risk of stroke or death, what are the effects of rate control versus rhythm control on mortality? Patients with atrial fibrillation Rate-control 4,060 Rhythm-control patients with nonvalvular atrial fibrillation All-cause Mortality Rate-control strategy (n=2,027) 25.9% 32.7% Follow-up: 5 years Primary End Point 5-year mortality (P=0.08) Secondary Outcomes Composite of death, stroke, major bleeding, or cardiac arrest Rhythm-control strategy (n=2,033) 26.7% 32.0% In patients with nonvalvular AF, there is no survival benefit between rate and rhythm control, but rhythm trends toward increased mortality. Wyse DG, et al. “A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation”. The New England Journal of Medicine. 2002. 347(23):1825-1833.