skip to main content

Early Rhythm Control in AF — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateArrhythmia & ElectrophysiologyEarly Rhythm Control in AFEECC

A 55-year-old man with recently diagnosed AF (first episode detected 3 months ago) and no structural heart disease is reviewed. The EAST-AFNET 4 trial findings are discussed. What did this trial demonstrate regarding early rhythm control?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Early rhythm control within 12 months of AF diagnosis reduces a composite of cardiovascular death, stroke, and HF hospitalisation compared with rate control

The EAST-AFNET 4 trial (2020) was a landmark study demonstrating that early rhythm control (initiated within 12 months of AF diagnosis) reduced the composite of CV death, stroke, and hospitalisation for HF or ACS by 21% compared with rate control. This reversed the previous understanding from AFFIRM/AF-CHF that rate and rhythm control were equivalent. The 2024 ESC AF Guidelines incorporated this evidence, recommending early rhythm control particularly in patients with recently diagnosed AF and cardiovascular risk factors (Class IIa). The benefit was independent of whether rhythm control was achieved with drugs or ablation.

Reference: ESC (2024): Guidelines for the Management of Atrial Fibrillation; EAST-AFNET 4 Trial