Atrial fibrillation: Rhythm versus rate control

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in primary care practice. Because the prevalence increases with age and the overall population is steadily aging, physicians of all specialties will be faced with managing more AF patients. AF independently increases mortality as well as the risk of stroke, subsequent coronary events, and congestive heart failure. Stroke prevention is particularly important in older patients, since they are at highest risk for these events. In addition, because of an increased risk of proarrhythmia, older adults should be managed cautiously with antiarrhythmic drugs. Data are now emerging on the optimal management of older patients with persistent AF. For each patient, physicians will have to answer the question: Is rhythm control better than rate control?