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. 2020 Dec 22;324(24):2497–2508. doi: 10.1001/jama.2020.23138

Figure 2. Change in Symptom Classification.

Figure 2.

The modified European Heart Rhythm Association (EHRA) score ranks atrial fibrillation (AF)–related symptoms and the effect these have on the patient’s daily life into 5 classes, ranging from asymptomatic (class 1) to disabling (class 4). The modified score subdivides class 2 into “a” (not troubling) and “b” (troubling) to identify patients in need of further intervention. The Sankey plots for participants that attended the 6-month follow-up are displayed with bars proportional to the number of patients in each modified EHRA class at that time point. There were no patients with a modified EHRA class 1 score at baseline in either randomized group. Comparisons of modified EHRA class were made using ordinal logistic regression across all categories for digoxin vs bisoprolol. The adjusted odds ratio at 6 months was 0.12 (95% CI, 0.06-0.25; P < .001) and at 12 months was 0.16 (95% CI, 0.08-0.33; P < .001). An odds ratio of less than 1 indicates superiority of digoxin at both time points. Data on the change in New York Heart Association class during the study appear in eFigure 5 in Supplement 3.