Rationale for the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. Card Electrophysiol Rev 2003;7:208–210
Bibliographic record
Abstract
The incidence of atrial fibrillation (AF) in patients with congestive heart failure (CHF) ranges from 10 % to 50%, with the highest incidence in those with the most severe symptoms [1-3]. Excessive ventricular rate, irregularity of ventricular response, and loss of atrial contraction associated with AF may result in adverse hemodynamic consequences and influence prognosis in patients with CHF [4-15]. Restoration of sinus rhythm has been associated with improvement in cardiac output, exercise capacity, and maximal oxygen consumption [5-11]. However, the impact of AF on survival remains controversial. Prior studies of AF and CHF were all nonrandomized comparisons and most were retrospective analyses [1, 2, 16-21]. Some studies suggested that AF had no effect on survival, but in some recent large reports, AF has been shown to be an independent risk factor for mortality or major morbidity. The recently published AFFIRM trial which compared the relative benefits of rhythm and rate control in the management of AF did not demonstrate any significant differences between the 2 groups in terms of overall mortality, morbidity and symptoms [22]. However, the AFFIRM trial was not designed and did not have the power to establish optimal management of AF in patients with CHF. This specific subset of patients, under represented in AFFIRM, are often felt by clinicians to require the additional contribution to cardiac output afforded by the atrial kick and despite the potential adverse effects related to antiarrhythmic therapy there exists a certain bias favouring rhythm control. However, the question of rate versus rhythm strategy in patients with heart failure has never been compared in an adequately powered randomized trial. The primary objective of the AF and Congestive Heart Failure (AF-CHF) trial is to determine whether restoring and maintaining sinus rhythm significantly reduces cardiovascular mortality compared with a rate control strategy in patients with AF and CHF [23]. AF-CHF is a prospective multicenter trial (130 centers in Canada,
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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) | 0.000 | 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 teacher head, 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".