Rate vs. rhythm control, in relation to EHRA score
Rhythm control was more often chosen in patients with higher EHRA symptom score (EHRA II-III) than in those with low EHRA symptom score. More than half of the highly symptomatic patients (EHRA III-IV) was not medicated with rhythm control therapy (Figure 1).
On univariate analysis, EHRA symptom score was not an independent predictor of rhythm control strategy (OR 0.99, 95% CI 0.90-1.10, p = 0.945). Moreover, EHRA symptom score was an independent predictor of rate control strategy on univariate analysis (OR 1.14, 95% CI 1.03-1.25, p = 0.011) but not on multivariate analysis.
Inadequately controlled heart rhythm (HR), (HR <50 or >110 beats per minute) was present in 21.3% of patients in rate control and 32.6% of patients in rhythm control strategy (supplementary Table 1).