Rate/Rhythm Control for Atrial Fibrillation

Rate versus Rhythm Control

1. AFFIRM (2002)
2. EAST-AFNET 4 demonstrated that early antiarrhythmic treatment may decrease long-term risk of MACE in recently diagnosed atrial fibrillation.

Rate Control

1. RACE-II
2. RATE-AF demonstrated that in patients with symptomatic permanent AF, digoxin leads to better QOL than bisoprolol.

Rhythm Control

1. CASTLE-AF (2018) showed that in patients with AF and symptomatic (NYHA II-IV) systolic heart failure (LVEF ≤ 35%), catheter ablation is associated with a 16.1% absolute reduction in death or hospitalization for heart failure when compared to medical therapy (rate or rhythm control).