Atrial Fibrillation: Rate Versus Rhythm Control

HCA Healthc J Med. 2023 Oct 30;4(5):329-339. doi: 10.36518/2689-0216.1564. eCollection 2023.

Abstract

Description Atrial fibrillation (AF) remains the most common arrhythmia worldwide and is expected to affect approximately 12 million individuals in the United States alone by 2030. Thromboembolic events remain a feared complication of AF and should be treated and risk-stratified utilizing the CHA2DS2-VASc scoring system. Other complications of AF span a wide spectrum from impaired quality of life (QoL) to an increase in all-cause mortality. Rate control strategies consist of controlling the ventricular rate and have been shown to be a safe and effective strategy for asymptomatic AF patients. In patients who are plagued with symptoms leading to impaired QoL or a decrease in exercise capacity, rhythm control with antiarrhythmic drugs or catheter ablation may be suitable options. Mortality benefits when comparing rate versus rhythm control remain equivocal when comparing multiple studies over the past decade.

Keywords: anti-arrhythmic drugs; atrial fibrillation (AF); atrial fibrosis; catheter ablation; electrical cardioversion; quality of life (QoL); rate control; rhythm control.

Publication types

  • Review

Grants and funding

This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare-affiliated entity.