Rate control in permanent atrial fibrillation

If a decision is made to adopt rate control as the form of treatment for atrial fibrillation (AF), it should be explained to the patient that the body usually becomes very quickly accustomed to permanent AF after the heart rate has been optimised (”AF with adequate rate control”). This information will also improve treatment compliance. In elderly patients (> 65 years) with mild symptoms, prognosis and the average quality of life are more or less equal whether the treatment approach chosen is rate control, where the aim is to slow down the ventricular response rate, or rhythm control, where the aim is the restoration of sinus rhythm with repeated cardioversions and antiarrhythmic medication .