Outcome parameters for trials in atrial fibrillation: executive summary

Eur Heart J. 2007 Nov;28(22):2803-17. doi: 10.1093/eurheartj/ehm358. Epub 2007 Sep 25.

Abstract

Atrial fibrillation (AF), the most common atrial arrhythmia, has a complex aetiology and causes relevant morbidity and mortality due to different mechanisms, including but not limited to stroke, heart failure, and tachy- or bradyarrhythmia. Current therapeutic options (rate control, rhythm control, antithrombotic therapy, 'upstream therapy') only prevent a part of this burden of disease. Several new treatment modalities are therefore under evaluation in controlled trials. Given the multifold clinical consequences of AF, trials in AF patients should assess the effect of therapy in each of the main outcome domains. This paper describes an expert consensus of required outcome parameters in seven relevant outcome domains, namely death, stroke, symptoms and quality of life, rhythm, left ventricular function, cost, and emerging outcome parameters. In addition to these 'requirements' for outcome assessment in AF trials, further, more detailed outcome parameters are described. In addition to a careful selection of a relevant primary outcome parameter, coverage of outcomes in all major domains of AF-related morbidity and mortality is desirable for any clinical trial in AF.

Publication types

  • Consensus Development Conference
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / economics
  • Atrial Fibrillation / mortality
  • Atrial Fibrillation / therapy*
  • Catheter Ablation / methods
  • Costs and Cost Analysis
  • Electric Countershock / methods
  • Electrocardiography
  • Heart Failure / etiology
  • Hospitalization
  • Humans
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Stroke / etiology
  • Treatment Outcome
  • Ventricular Dysfunction, Left / etiology

Substances

  • Anti-Arrhythmia Agents
  • Anticoagulants