Rate Control for Atrial Fibrillation: Can We Relax?

In a randomized trial, patients whose heart rates were strictly controlled fared no better than those treated more leniently — at least in the short term.

In many patients with relatively few symptoms, atrial fibrillation (AF) can be managed with heart rate control alone, without rhythm correction. Traditionally, the target in such cases has been the rate that would be expected in a similar patient in sinus rhythm. However, a retrospective analysis of data from two trials of rate versus rhythm control showed no clinical benefit from such strict control. In the current prospective Dutch trial, investigators randomized 614 patients with AF suitable for management with rate control alone to either strict control (<80 beats/minute at rest and <110 beats/minute during moderate exercise) or lenient control (<110 beats/minute at rest).

At the end of the dose-titration phase of the trial, the mean res…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate