Atrial Fibrillation: Rate Versus Rhythm Control

Authors

Carlos E. Vargas, Corpus Christi Medical CenterFollow
Mina Bhatnagar, MountainView Hospital, Las Vegas, NVFollow
Haris Ahmed, HCA Houston Kingwood HospitalFollow
Michael G. Flynn, HCA Healthcare GME Knowledge ManagementFollow
Thomas Alexander, Corpus Christi Medical CenterFollow

Keywords

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

Disciplines

Cardiovascular Diseases | Circulatory and Respiratory Physiology

Abstract

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.

Recommended Citation

Vargas, Carlos E.; Bhatnagar, Mina; Ahmed, Haris; Flynn, Michael G.; and Alexander, Thomas (2023) "Atrial Fibrillation: Rate Versus Rhythm Control," HCA Healthcare Journal of Medicine: Vol. 4: Iss. 5, Article 1.
DOI: 10.36518/2689-0216.1564
Available at: https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol4/iss5/1