NEW TRIALS IN ATRIAL-FIBRILLATION

New Trials in Atrial Fibrillation. Large-scale clinical trials in atri al fibrillation (AF) now are addressing issues other than that of thro mboembolic prophylaxis. The ''rate versus rhythm'' debated is fundamen tal-whether to accept the occurrence of AF and attempt control of the ventricular rate or to strive for the restoration and maintenance of s inus rhythm. The AFFIRM, PIAF, and RACE trials will provide informatio n about the efficacy, costs, adverse effects, and benefits of attempti ng to maintain sinus rhythm. Atrial pacing is associated with less AF than ventricular pacing, and trials (AFT, SYNBIAPACE, and DAPPAF) now are assessing the antiarrhythmic efficacy of atrial pacing, including dual-site pacing and special algorithms compared with no pacing.