Abstract 4863: Rhythm Versus Rate Control Strategies In Heart Failure Patients With Atrial Fibrillation: Impact On Lv Function And Functional Status: Echocardiographic Insights From Af-chf
Bibliographic record
Abstract
Background: In heart failure patients, the recently published AF-CHF (Atrial Fibrillation in Congestive Heart Failure) trial did not demonstrate the superiority of a rhythm control (RhyC) over a rate control (RaC) strategy in terms of cardiovascular mortality. Nevertheless, the deleterious hemodynamic effects of AF can lead to further decrease in LV function and symptoms progression. This AF-CHF echocardiographic sub-study was designed to compare the effects of the two treatment strategies (RhyC and RaC) on LV ejection fraction (LVEF), chamber dimensions and volumes, valvular regurgitation, functional status and exercise tolerance. Methods: 59 patients (29 RhyC:30 RaC) enrolled in AF-CHF were prospectively followed in this echocardiography study, with a standardized exam at baseline and 12 months. The primary endpoint was the change in LVEF. Results: (Table 1 ) Mean LVEF at baseline was severely depressed (RhyC:27.0±4.9% and RaC:27.6±7.4%, p=0.73), with significant improvement at follow-up for both groups. Other echocardiographic parameters were unchanged at follow-up, including changes in LV and LA volumes and valvular regurgitation. Clinically, mean six-minute walked distance increased significantly in both groups as did NYHA class without any additional benefit for the rhythm control strategy (both p=NS). Conclusion: In patients with HF and AF, improvements in LVEF and functional status are observed at 12 months without any additional benefit of rhythm control over a rate control strategy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".