- Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
ACC/AHA would like to suggest updating already existent AHRQ systematic reviews with the questions and evidence gaps addressed therein, published in 2013.
Treatment of Atrial Fibrillation (Posted: 6/28/13)
http://www.effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1559
- Describe why this topic is important.
Describe why this topic is important.
Treatment of Atrial Fibrillation:
- With regards to rate control drugs: Quite a few outcome comparisons had inadequate strength of evidence and although studies focused on control of ventricular rate, there was a lack of evidence for safety and efficacy of therapies on final outcomes.
- With regards to the strict vs. lenient rate-control strategies: The strength of evidence was either low or insufficient regarding outcomes such as mortality, CV hospitalizations, thromboembolic events, and quality of life (QoL) etc.
- With regards to the rate control procedures vs. drugs or vs. others: The strength of evidence for most of the important outcomes was weak or inadequate.
- With regards to antiarrythmic drugs and electrical cardioversions: The strength of evidence although high for biphasic vs. monophasic, energy protocols, and the pharmacological cardioversion for restoration of sinus rhythm; still deemed to be either low or inadequate for restoration/maintenance of sinus rhythm and recurrence of AF for cardioversions.
- With regards to procedural rhythm-control therapies: The strength of evidence seemed to be mostly insufficient all across the board for not only restoration/maintenance of sinus rhythm and recurrence of AF but also with regards to comparisons for all-cause mortality, CV/AF hospitalizations, heart failure, QoL, embolic and bleeding events.
- With regards to comparative effectiveness of rate and rhythm control strategies: The analysis confirmed that rate control are superior to rhythm control strategies suggesting trends on the benefit of rhythm-control strategies on heart failure symptoms, although it did not reach statistical significance.
- How will an answer to your research question be used or help inform decisions for you or your group?
ACC/AHA writing committees use evidence-based methodologies to search the literature and formulate recommendations. Independent and quality systematic reviews by organizations such as AHRQ help inform the guideline writing committees to frame trust worthy guidelines.
- Other Information About You: (optional)
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- Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
- Associate Science and Medicine Advisor, Clinical Research and Policy
- If you are you making a suggestion on behalf of an organization, please state the name of the organization
- AHA and ACC
- Please tell us how you heard about the Effective Health Care Program
