Outcomes after rhythm versus rate control in patients with atrial fibrillation: the international prospective GARFIELD registry
Bibliographic record
Abstract
Purpose: To determine whether rhythm control confers clinical benefits over rate control in patients with newly diagnosed atrial fibrillation (AF). Methods: Adults (≥18 y) with newly diagnosed non-valvular AF and ≥1 stroke risk factor were enrolled (540 sites, 19 countries). Cox proportional hazards model was used to determine the effects of rhythm vs rate control at 1 year, adjusted for antithrombotic treatments and components of CHA2DS2-VASc score. Results: Of the 10,614 adults enrolled, baseline and follow-up data were available in 9258 and 8839 patients, respectively. Patients in the rate control group were older, had higher risk scores and were more likely to have antithrombotic treatments initiated at AF diagnosis (Table 1). Rhythm control was associated with a significantly lower risk of death (absolute rates 1.6% vs 2.7%; adjusted HR 0.73, 95% CI 0.53–0.98; p=0.039) and a numerically lower risk of stroke/systemic embolism (0.9% vs 1.3%; HR 0.68, 95% CI 0.45–1.04; p=0.075). There were no differences in acute coronary syndrome, major bleeding or intracranial haemorrhage. Baseline characteristics AP, antiplatelet; VKA, vitamin K antagonist. Conclusions: Among patients with newly diagnosed non-valvular AF and ≥1 stroke risk factor, rhythm control seems to be associated with clinical benefits over rate control. However, the two groups differed in many respects, and we may not have been able to adjust for residual confounding. The results must therefore be interpreted with caution.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".