{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:12:45Z","timestamp":1784607165607,"version":"3.55.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,12,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Rhythm control is associated with better cardiovascular outcomes than usual care among patients with recently diagnosed atrial fibrillation (AF). This study investigated the effects of rhythm control compared with rate control on the incidence of stroke, heart failure, myocardial infarction, and cardiovascular death stratified by timing of treatment initiation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a retrospective population\u2010based cohort study including 22\u00a0635 patients with AF newly treated with rhythm control (antiarrhythmic drugs or ablation) or rate control in 2011 to 2015 from the Korean National Health Insurance Service database. Propensity overlap weighting was used. Compared with rate control, rhythm control initiated within 1\u00a0year of AF diagnosis decreased the risk of stroke. The point estimates for rhythm control initiated at selected time points after AF diagnosis are as follows: 6\u00a0months (hazard ratio [HR], 0.76; 95% CI, 0.66\u20130.87), 1\u00a0year (HR, 0.78; 95% CI, 0.66\u20130.93), and 5\u00a0years (HR, 1.00; 95% CI, 0.45\u20132.24). The initiation of rhythm control within 6\u00a0months of AF diagnosis reduced the risk of hospitalization for heart failure: 6\u00a0months (HR, 0.84; 95% CI, 0.74\u20130.95), 1\u00a0year (HR, 0.96; 95% CI, 0.82\u20131.13), and 5\u00a0years (HR, 2.88; 95% CI, 1.34\u20136.17). The risks of myocardial infarction and cardiovascular death did not differ between rhythm and rate control regardless of treatment timing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Early initiation of rhythm control was associated with a lower risk of stroke and heart failure\u2013related admission than rate control in patients with recently diagnosed AF. The effects were attenuated as initiating the rhythm control treatment later.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023055","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T11:49:28Z","timestamp":1639136968000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Comparative Effectiveness of Early Rhythm Control Versus Rate Control for Cardiovascular Outcomes in Patients With Atrial Fibrillation"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-450X","authenticated-orcid":false,"given":"Daehoon","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-1742","authenticated-orcid":false,"given":"Pil\u2010Sung","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology CHA Bundang Medical CenterCHA University Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng Chan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Yonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunsun","family":"Jang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Tae","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4200-3456","authenticated-orcid":false,"given":"Tae\u2010Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3256-3620","authenticated-orcid":false,"given":"Hui\u2010Nam","family":"Pak","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7268-0741","authenticated-orcid":false,"given":"Moon\u2010Hyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart &amp; Chest Hospital Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung\u2010Hoon","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Cardiology CHA Bundang Medical CenterCHA University Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-7225","authenticated-orcid":false,"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000665"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312930"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708789"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021375"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021328"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.3.258"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2019422"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n991"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-305152"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.015740"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx316"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30668-8"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.2016.1260466"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803778"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.092494"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02035.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707855"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109867"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.107.754564"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.12.025"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.023055","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:18:10Z","timestamp":1715599090000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.023055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,21]]},"references-count":22,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2021,12,21]]}},"alternative-id":["10.1161\/JAHA.121.023055"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.023055","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,21]]},"assertion":[{"value":"2021-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e023055"}}