Real-life observations of clinical outcomes with rhythm- and rate-control therapies for atrial fibrillation RECORDAF (Registry on Cardiac Rhythm Disorders Assessing the Control of Atrial Fibrillation)

J Am Coll Cardiol. 2011 Jul 26;58(5):493-501. doi: 10.1016/j.jacc.2011.03.034.


Objectives: RECORDAF is the first worldwide, prospective, observational survey of management of atrial fibrillation (AF) in unselected, community-based patients.

Background: Primary outcomes were therapeutic success and clinical outcomes associated with rhythm-control and rate-control strategies.

Methods: Patients with recent-onset AF were included (n = 5,604). Treatment strategy (rhythm control or rate control) was noted at baseline. Follow-up was 12 months. Therapeutic success required that strategy was unchanged without clinical events. Further maintenance of sinus rhythm was required in the rhythm-control group, and heart rate ≤80 beats/min in the rate-control group.

Results: Data from 5,171 patients were assessable. Therapeutic success was 54% overall (rhythm control 60% vs. rate control 47%), a result driven by control of AF: rhythm control, 81% vs. rate control, 74%. After adjustment for propensity score quintiles, the rhythm-control strategy was significantly related to superior therapeutic success (odds ratio: 1.34, 95% confidence interval: 1.15 to 1.55; p = 0.0002). Clinical events occurred in 18% of patients. The arrhythmia management strategy was not predictive of clinical events. The type (persistent), presence at baseline visit, and duration (>3 months) of AF, together with age older than 75 years and the presence of heart failure, predicted progression to permanent AF. The choice of rhythm control reduced the likelihood of AF progression (odds ratio: 0.20, 95% confidence interval: 0.17 to 0.25; p < 0.0001).

Conclusions: Clinical outcomes in AF patients were driven mainly by hospitalizations for arrhythmia/proarrhythmia and other cardiovascular causes, but not by the choice of rate or rhythm strategy. Rhythm-control patients progressed less rapidly to permanent AF.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Aged
  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / therapy*
  • Calcium Channel Blockers / therapeutic use*
  • Cardiac Glycosides / therapeutic use
  • Catheter Ablation
  • Disease Progression
  • Electric Countershock
  • Electrocardiography
  • Female
  • Heart Failure / classification
  • Heart Failure / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology
  • Pacemaker, Artificial
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prognosis
  • Prospective Studies
  • Registries
  • Stroke / epidemiology
  • Stroke / prevention & control
  • Time Factors
  • Vitamin K / antagonists & inhibitors


  • Anti-Arrhythmia Agents
  • Calcium Channel Blockers
  • Cardiac Glycosides
  • Platelet Aggregation Inhibitors
  • Vitamin K