Key result
Rate control remains the preferred initial AF strategy over rhythm control to avoid antiarrhythmic toxicity.
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This review highlights that both rate and rhythm control are acceptable strategies for managing atrial fibrillation, emphasizing the need for individualized patient care.
Atrial fibrillation (AF) is the most common cardiac arrhythmia in adults and accounts for approximately one-third of all arrhythmias requiring admission to the hospital. Treatment strategies are determined by the classification of AF, whether paroxysmal or persistent, as well as numerous patient-specific cardiac and medical considerations (eg, pre-existing congestive heart failure or previous myocardial infarction). Thromboembolic risk also influences whether patients are treated with antiplatelet or anticoagulant medications. Several large clinical trials have deemed both rate and rhythm control acceptable treatment strategies for AF. Additionally, nonpharmacologic approaches such as surgical and electroablative options also exist. The clinician must exercise sound clinical judgment when deciding which treatment approach is best suited for a particular patient.
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Schapira et al. (2010) conducted a review in Atrial Fibrillation. Rate control versus rhythm control was evaluated. Rate control and rhythm control are both acceptable treatment strategies for atrial fibrillation, with rate control often preferred initially to avoid antiarrhythmic drug toxicity.
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