Rate Versus Rhythm Control for Atrial Fibrillation

Atrial fibrillation (AF) is an arrhythmia characterized by disorganized atrial activity with an associated unevenly irregular ventricular response on an electrocardiogram. It is the most common sustained arrhythmia, with a lifetime risk of 25% in patients older than 40 years old. The incidence of AF...

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Bibliographic Details
Published in:Permanente journal 2024-03, Vol.28 (1), p.81-85
Main Authors: Shin, Edward D, Tran, H Nicole, Ramalingam, Nirmala D, Liu, Taylor, Fan, Eugene
Format: Article
Language:English
Subjects:
Adult
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - complications
Atrial Fibrillation - therapy
Electric Countershock
Heart Failure - chemically induced
Heart Rate
Humans
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Summary:Atrial fibrillation (AF) is an arrhythmia characterized by disorganized atrial activity with an associated unevenly irregular ventricular response on an electrocardiogram. It is the most common sustained arrhythmia, with a lifetime risk of 25% in patients older than 40 years old. The incidence of AF increases with age and is associated with an increased risk for heart failure, stroke, adverse cardiac events, and dementia. The 2 main aims of AF treatment include anticoagulation for thromboembolism prophylaxis as well as rate vs rhythm control. The focus of this article will be on the treatment strategies in managing AF. Rate control refers to the use of atrioventricular nodal blocking medications, including beta blockers and calcium channel blockers, to maintain a goal heart rate. Rhythm control, on the other hand, refers to a treatment strategy focused on the use of antiarrhythmic drugs (AAD), cardioversion, and ablation to restore and to maintain a patient in sinus rhythm. Currently, the ideal treatment strategy remains greatly debated. Thus, we hope to compare the risks and benefits of rate to rhythm control to highlight how patients with AF are managed here at Kaiser Permanente Northern California.
ISSN:1552-5775
1552-5775
DOI:10.7812/TPP/23.151