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The AFFIRM study was a randomized comparison of 2 strategies for management of patients with atrial fibrillation. Patients with atrial fibrillation requiring therapy, who also had one or more risk factors for stroke or death, were randomized to either a rate control strategy of cardioversion and treatment with antiarrhythmic drugs or a rate control strategy using atrioventricular (AV) nodal blocking agents to control ventricular response. Results of this study suggest that if an effective method for maintaining sinus rhythm with fewer adverse effects were available, it might improve survival.

Determinants of Survival in Atrial Fibrillation