Study: Simple heart treatment works

The preferred way of treating common heart rhythm problems is actually no better -- and perhaps even worse -- than a simpler approach using cheaper drugs, according to new research that could affect millions of people.

Doctors have long assumed that the best way to treat the heart irregularity called atrial fibrillation is to get the heart back to a regular rhythm and maintain it, using electric shock or strong drugs. Restoring normal rhythm, or sinus rhythm, was thought to reduce the risk of strokes and death, make patients feel better and allow them to stop taking blood thinners.

"It just made a lot of sense. After all, God made you in sinus rhythm. So we should try to keep you there," said Dr. D. George Wyse of the University of Calgary in Alberta, the lead researcher for one study.

If that method doesn't work, doctors turn to a second approach -- using simpler, usually cheaper medications to slow down the heart rate and ease symptoms, which include palpitations, dizziness and shortness of breath. The abnormal rhythm continues and patients have to keep taking blood thinners to prevent blood clots.

But Wyse said doctors began questioning whether restoring a normal rhythm is really necessary. After all, the drugs do not work very well and can have serious side effects, including triggering a potentially fatal irregular heartbeat, he said.

The two approaches were compared in studies reported in today's New England Journal of Medicine.

In a study of 4,060 patients in the United States and Canada, researchers found there was no significant difference in survival in the two groups and a hint of better survival in the rate-control group. There was no difference in the number of strokes and the rhythm-control group had more hospitalizations and more serious side effects.

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