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To Be or Not To Be in Normal Sinus Rhythm: What Do We Really Know?

Tristram D. Bahnson, MD; and Augustus O. Grant, MB, PhD
[+] Article, Author, and Disclosure Information

From Duke University Medical Center, Durham, NC 27710.

Potential Financial Conflicts of Interest: Honoraria: A.O. Grant (Guidant Corp., Medtronic Corp.).

Requests for Single Reprints: Augustus O. Grant, MB, PhD, Cardiology Division, Box 3504, Duke University Medical Center, Durham, NC 27710; e-mail, grant007@mc.duke.edu.

Current Author Addresses: Drs. Bahnson and Grant: Atrial Fibrillation Clinic, Duke University Medical Center, Durham, NC 27710.

Ann Intern Med. 2004;141(9):727-729. doi:10.7326/0003-4819-141-9-200411020-00016
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The high prevalence of atrial fibrillation and the shortcomings of currently available therapies fuel continued discussion of best clinical practice. The recent publication of the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial (1), the largest randomized trial of management strategies for atrial fibrillation, seemed to resolve a major issue: Rate control and the use of anticoagulation are equivalent to restoring and maintaining normal sinus rhythm by using contemporary antiarrhythmic drugs.

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