eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2018-06-25 11 2 609 620 10.13005/bpj/1413 20680 article Abdelrahman Ibrahim Abushouk 1,2 Aya Ashraf Ali 3,4 Ahmed Abdou Mohamed 3,4 Loalo'a El-Sherif 3,4 Mennat-Allah Abdelsamed 4,5 Mohamed Kamal Mohamed 4,5 Faculty of Medicine, Ain Shams University, Cairo, Egypt. NovaMed Medical Research Association, Cairo, Egypt. Faculty of Medicine, Minia University, Minia, Egypt. Minia Medical Research Society, Minia University, Minia, Egypt. Faculty of Clinical Pharmacy, Minia University, Minia, Egypt. Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt. Atrial fibrillation (AF) is a common, sustained tachyarrhythmia, associated with an increased risk of mortality and thromboembolic events. We performed this meta-analysis to compare the clinical efficacy of rate and rhythm control strategies in patients with AF in a meta-analysis framework. A comprehensive search of PubMed, OVID, Cochrane-CENTRAL, EMBASE, Scopus, and Web of Science was conducted, using relevant keywords. Dichotomous data on mortality and other clinical events were extracted and pooled as risk ratios (RRs), with their 95% confidence-interval (CI), using RevMan software (version 5.3). Twelve studies (8451 patients) were pooled in the final analysis. The overall effect-estimate did not favor rate or rhythm control strategies in terms of all-cause mortality (RR= 1.13, 95% CI [0.88, 1.45]), stroke (RR= 0.97, 95% CI [0.79, 1.20]), thromboembolism (RR= 1.06, 95% CI [0.64, 1.76]), and major bleeding (RR= 1.10, 95% CI [0.90, 1.35]) rates. These findings were consistent in AF patients with concomitant heart failure (HF). The rate of rehospitalization was significantly higher (RR= 0.72, 95% CI [0.57, 0.92]) in the rhythm control group, compared to the rate control group. In younger patients (<65 years), rhythm control was superior to rate control in terms of lowering the risk of all-cause mortality (p=0.0003), HF (p=0.003) and major bleeding (p=0.02). In older AF patients and those with concomitant HF, both rate and rhythm control strategies have similar rates of mortality and major clinical outcomes; therefore, choosing an appropriate strategy should consider individual variations, such as patient preferences, comorbidities, and treatment cost. https://biomedpharmajournal.org/vol11no2/rhythm-versus-rate-control-for-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-trials/ Atrial Fibrillation Meta-analysis Rate Control Rhythm Control