ATRIAL-FIBRILLATION - MAINTAINING SINUS RHYTHM VERSUS VENTRICULAR RATE CONTROL - THE PIAF TRIAL

The PIAF Study. Introduction: In patients with persistent atrial fibri llation, therapy can be directed toward restoration of sinus rhythm or control of ventricular rate only. There are no prospective data in th e literature comparing both treatement strategies. Methods and Results : Patients with symptomatic persistent atrial fibrillation (duration g reater than or equal to 7 and less than or equal to 360 days) will be randomized to control of ventricular rate only or to conversion therap y. All patients will be followed for 12 months, Diltiazem is used as t he primary therapy for rate control, whereas amiodarone will be admini stered for restoration and maintenance of sinus rhythm. The primary en dpoint of the trial is the recurrence of symptomatic tachyarrhythmic e pisodes in patients randomized to rate control and recurrent atrial fi brillation in the alternative treatment arm. A number of secondary end points also will be investigated. The trial is expected to end its fol low-up in the summer of 1998. Conclusion: PIAF (Pharmacological Interv ention in Atrial Fibrillation) is one of several trials designed to ev aluate the optimal treatment strategy in patients,vith persistent atri al fibrillation, The results hopefully will help to improve care of pa tients with this common rhythm disorder.