Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.
Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.
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DOI：
10.1007/s12471-013-0428-5
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发表时间：
2013-07
影响因子：
2
通讯作者：
Van Gelder, I. C.
中科院分区：
文献类型：
--
作者：
Alings, M.;Smit, M. D.;Moes, M. L.;Crijns, H. J. G. M.;Tijssen, J. G. P.;Brugemann, J.;Hillege, H. L.;Lane, D. A.;Lip, G. Y. H.;Smeets, J. R. L. M.;Tieleman, R. G.;Tukkie, R.;Willems, F. F.;Vermond, R. A.;Van Veldhuisen, D. J.;Van Gelder, I. C.
心房颤动（AF）的心律控制是麻烦的，因为它是由结构重构引起的进行性。上游治疗是指旨在改变心房底物的治疗干预，从而预防房颤。预防心力衰竭早期房颤的常规与积极的上游节律控制（RACE 3）研究假设，与传统的心律控制相比，在电转复的早期房颤和轻度至中度早期收缩期或舒张期心力衰竭患者中，积极的上游节律控制可增加窦性心律的持久性。RACE 3是一项前瞻性、随机、开放、多国、多中心试验。上游节律控制包括血管紧张素转换酶抑制剂和/或血管紧张素受体阻阻剂、矿化皮质激素受体拮抗剂、他汀类药物、心脏康复治疗，以及关于饮食限制、运动维持和药物依从性的强化咨询。常规心律控制包括常规心律控制治疗，不包括心脏康复治疗和强化咨询。在两组中，我们尽一切努力使患者保持心律控制策略，如果房颤复发，可以采用离子通道抗心律失常药物或肺静脉消融。总共纳入250名患者。如果上游治疗能有效改善窦性心律的维持，它可能成为一种新的心律控制方法，支持传统的药物和非药物心律控制。
Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.
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影响因子：
39.3
作者：
Gillis, Anne M.;Morck, Margaret;Wyse, D. George
通讯作者：
Wyse, D. George
影响因子：
6.1
作者：
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通讯作者：
Crijns, Harry
影响因子：
2.7
作者：
Sicouri S;Cordeiro JM;Talarico M;Antzelevitch C
通讯作者：
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影响因子：
39.3
作者：
Milliez, P;DeAngelis, N;Hatem, SN
通讯作者：
Hatem, SN
DOI：
10.1111/j.1540-8167.2006.00372.x
发表时间：
2006-05-01
影响因子：
2.7
作者：
Shroff, SC;Ryu, K;Stambler, BS
通讯作者：
Stambler, BS