Effect of Lenient Versus Strict Rate Control on Cardiac Remodeling in Patients With Atrial Fibrillation

Marcelle D. Smit, Harry J. G. M. Crijns, Jan G. P. Tijssen, Hans L. Hillege, Marco Alings, Ype S. Tuininga, Hessel F. Groenveld, Maarten P. Van den Berg, Dirk J. van Veldhuisen, Isabelle C. Van Gelder*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives The aim of this study was to evaluate echocardiographic remodeling in permanent atrial fibrillation (AF) patients treated with either lenient or strict rate control. Background It is unknown whether in permanent AF, lenient rate control is associated with more adverse cardiac remodeling than strict rate control. Methods Echocardiography was conducted at baseline and at follow-up in 517 patients included in the RACE II (RAte Control Efficacy in permanent atrial fibrillation II) trial. Echocardiographic parameters were compared between patients randomized to lenient rate control (n = 261) or strict rate control (n = 256). Results Baseline echocardiographic parameters were comparable between patients randomized to lenient and strict rate control. Between baseline and follow-up, significant adverse atrial or ventricular remodeling was not observed in either group. There were also no significant differences in atrial and ventricular remodeling between patients who continuously had heart rates between 80 and 110 beats/min and patients who continuously had heart rates
Original languageEnglish
Pages (from-to)942-949
JournalJournal of the American College of Cardiology
Issue number9
Publication statusPublished - 23 Aug 2011


  • atrial fibrillation
  • echocardiography
  • rate control
  • remodeling

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