Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF)
Status:
Completed
Trial end date:
2019-09-16
Target enrollment:
Participant gender:
Summary
Atrial fibrillation is a common heart rhythm disturbance, causing important discomfort for
patients, a high risk of stroke, frequent hospital admissions and a two-fold increase in
death. The number of patients with this condition are expected to double in the next 20
years. Medications to control heart-rate are used in the majority of patients, although the
choice of agent is often guided by local preference rather than evidence from controlled
trials. Despite the fact that patients with atrial fibrillation have high rates of other
cardiac conditions such as heart failure, clinicians have insufficient evidence to
personalise the use of different therapies. This feasibility study will allow us to develop a
range of methods that can characterise patients according to the pumping and relaxing
function of the heart, the burden of symptoms and to identify new blood markers. In this way,
the investigators hope to improve clinical practice guidelines, allowing doctors to prescribe
appropriate treatments for the right patients.
The research will be focused around a randomised trial of two medication strategies,
providing much-needed data on the comparison of digoxin and beta-blockers (two commonly-used
drugs in patients with atrial fibrillation). It will also allow us to identify the best way
to record patient-reported quality of life and develop robust techniques to determine heart
function using non-invasive imaging, facilitating the conduct of a large-scale clinical
trial. The key objectives of the research programme are to define the optimal medications for
patients with atrial fibrillation and identify the most valid, reproducible and
cost-effective methods to examine patients. The ultimate aim of the project is to improve
clinical outcomes in atrial fibrillation, benefiting patients, the National Health Service
and the global community.