Table 1.
Characteristics of included studies.
| Study | Kelly 2019 [16] | Machino–Ohtsuka 2019 [17] | Slee 2019 [18] | Zhang 2020 [19] | Zhirov 2019 [20] |
|---|---|---|---|---|---|
| Types | Retro | Retro | Retro | Retro | Pros |
| Country | USA | Japan | USA | USA | Russia |
| Participants | HF patients >65 years old with concurrent AF who were discharged alive | HFpEF patients >20 years old with AF | >65 years old HF patients with prior AF who were at high risk of stroke | HF patients >18 years old with prior or current AF | HF patients >18 years old with prior or current non-valvular AF |
| Database | Medicare data from 2008 to 2014 | Multicenter from 2012 to 2015 | AFFIRM registry | REP from 2000 to 2014 | Multicenter from 2015 to 2016 |
| Exclusion | Patients who did not receive either rhythm or rate control strategies, patients who were not admitted | Younger than 20 years old, prior MI, valvular disease requiring intervention, history of pacemaker implantation, severe lung and liver disease | N/A | Patients without documented EF, patients with AF who died within 1 year | Recent stroke/TIA, recent MI, valvular AF, BiV implantation, severe life-limiting comorbidities, recent VTE |
| HFpEF criteria | HF with EF > 50% | HF with EF > 50% | HF with EF > 40% | HF with EF > 50% | HF with EF > 50% |
| Mean EF (%) | 58.0 | 63.8 ± 8 | N/A | 61.2 ± 6.7 | 60.0 ± 5.0 |
| Mean age (years) | 83.0 | 71 ± 8 | 70.9 ± 8.7 | 79.2 ± 11.1 | 72.0 |
| Sex (Female%) | 65.8 | 39.9 | 40.1 | 60.2 | 65.4 |
| CHA2DS2-VASc | N/A | Rate: 4.2 ± 1.4, Rhythm: 3.9 ± 1.3 |
N/A | Rate: 5.2 ± 1.7, Rhythm: 4.7 ± 2 |
N/A |
| Total participants | 15,682 | 283 | 349 | 447 | 387 |
| Hypertension | Rate: 81.9%, Rhythm: 83.8% |
Rate: 75.0%, Rhythm: 80.4% |
Rate: 80.1%, Rhythm: 76.4% |
Rate: 85.4%, Rhythm: 75.0% |
68% |
| Diabetes | Rate: 36.2%, Rhythm: 36.0% |
Rate: 31.3%, Rhythm: 34.6% |
Rate: 33.3%, Rhythm: 20.8% |
Rate: 36.8%, Rhythm: 30.0% |
23% |
| Coronary artery disease | Rate: 45.8%, Rhythm: 48.7% |
Rate: 17.0%, Rhythm: 25.2% |
Rate: 17.0%, Rhythm: 10.7% |
Rate: 16.5%, Rhythm: 15.0% |
70% |
| CVA/TIA | Rate: 19.3%, Rhythm: 17.5% |
Rate: 9.1%, Rhythm: 12.1% |
Rate: 11.7%, Rhythm: 16.9% |
Rate: 22.6%, Rhythm: 2.5% |
15% |
| Proportion of paroxysmal AF | N/A | 37.4% | N/A | N/A | 37.2% |
| AF duration (years) | N/A | 5.8 ± 6.7 | N/A | 4.2 (IQR 2–9) | N/A |
| Mean follow up (months) | 12 | 24 | 48 | 49.2 | 12 |
| Proportion of rhythm control | 11.8% | 37.8% | 51.0% | 15.9% | 40.6% |
| Proportion of rate control | 78.2% | 62.2% | 49.0% | 74.1% | 59.4% |
| Adjusted variables | Age, sex, race, prior MI, hypertension, hyperlipidemia, smoking history, prior CVA/TIA, DM, CKD, anemia, PVD, prior HF, COPD |
Age, sex, body mass index, vital signs, prior MI, hypertension, hyperlipidemia, CKD, DM, medications, laboratory data, LVEF, LA volume, E/E’, TRPG, GLS, LV mass | Age, sex, failed antiarrhythmic drugs, hypertension, MI, stroke, DM, hypertension, cardiomyopathy, valvular heart disease | Age, sex, time interval from HF to AF, body mass index, hypertension, COPD, prior MI, prior stroke | N/A |