Study information

Recruiting status

Study completed

Recruitment start





Clinical Trials Registration



Guideline relevant study



Operative contact: Heidi Oellers

Early treatment of atrial fibrillation for stroke prevention trial (EAST – AFNET 4)

Atrial fibrillation is by far the most common cardiac arrhythmia and affects approx. 1 to 2 percent of the European population. Atrial fibrillation is indeed not immediately life-threatening, but it can have serious consequences. So, patients with atrial fibrillation have a fivefold higher risk of having a stroke.

With the treatment options available so far, i.e., especially with blood thinners and with rate control for atrial fibrillations, these serious consequences of atrial fibrillation can only be partially prevented.

The possibilities of rhythm control treatment of atrial fibrillation have significantly broadened in recent years: The so-called catheter ablation of atrial fibrillation has been an established procedure to prevent in particular early forms of atrial fibrillation (paroxysmal, non-persistent atrial fibrillation) for some years.

In the EAST – AFNET 4 study, atrial fibrillation shall be detected early on. Patients who are diagnosed with atrial fibrillation for the first time or patients who have suffered from atrial fibrillation for less than 1 year will be randomised into a group with early rhythm control care or a group with the usual care.

Patients in the early care group will be treated corresponding to the current ESC guidelines for the treatment of atrial fibrillation. They will also undergo a catheter ablation or will receive an antiarrhythmic therapy.

The patients in the usual care group will be treated with the treatment measures usually used nowadays in accordance with the guidelines (anticoagulation, rate control).

The aim of the EAST- AFNET 4 study is to investigate whether early, comprehensive rhythm control treatment of atrial fibrillation using safe antiarrhythmic agents and catheter ablation is suitable to prevent cardiovascular complications associated with long-term atrial fibrillation.

This is a phase IV study in accordance with the Medicinal Products Act (AMG). The study will be conducted at over 160 sites in 11 European countries. All patients will be monitored up to 2 years after the end of the study within the scope of follow-up visits.

The AFNET study has been partially funded by the DZHK from 2015 to 2020.

EAST-AFNET 4 Homepage


Check out all publications of EAST-AFNET 4.

Principal Investigators

Paulus Kirchhof (Birmingham, Münster)

Press releases and news

AFNET trials provide key evidence for atrial fibrillation guideline recommendations

Investigator-initiated trials led by the German Atrial Fibrillation NETwork (AFNET) provide evidence...

People with atrial fibrillation benefit from early rhythm maintenance (EAST-AFNET 4 trial)

Patients with atrial fibrillation benefit from early rhythm-maintenance therapy. It prevents...

Stabilizing the heart rhythm early in all types of atrial fibrillation (Study EAST – AFNET 4)

Patients with atrial fibrillation should start therapy that controls the heart rhythm as early as...

Atrial fibrillation: Early rhythm control also beneficial in heart failure (Study EAST–AFNET-4)

Early initiation of rhythm control therapy is associated with clinical benefit in patients with...

Atrial fibrillation: Early rhythm control therapy prevents complications (Study EAST – AFNET 4)

The EAST-AFNET 4 study provides new evidence on how atrial fibrillation can best be treated in early...