title: Atrial fibrillation management: evaluating rate vs rhythm control.
abstract: Atrial fibrillation (AF) is an increasing global issue leading to increased hospitalizations, adverse health related events and mortality. This review focuses on the management of atrial fibrillation, in particular in the past decade, comparing two major strategies, rate or rhythm control. We evaluate the evidence for each strategy, pharmacological options and the increasing utilization of invasive techniques, in particular catheter ablation and use of implantable cardiac pacing devices. Pharmacological comparative trials evaluating both strategies have shown rate control being non-inferior to rhythm control for clinical outcomes of mortality and other cardiovascular events (including stroke). Catheter ablation techniques, involving radiofrequency ablation and recently cryoablation, have shown promising results in particular with paroxysmal AF. However, persistent AF provides ongoing challenges and will be a particular focus of continued research.
authors.affiliation: a Division of Cardiology, Department of Medicine , Western University , London , Canada.
authors.forename: Tuan
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: a Division of Cardiology, Department of Medicine , Western University , London , Canada.
authors.forename: Umjeet
authors.initials: U
authors.lastname: Jolly
authors.affiliation: a Division of Cardiology, Department of Medicine , Western University , London , Canada.
authors.forename: Kiran
authors.initials: K
authors.lastname: Sidhu
authors.affiliation: a Division of Cardiology, Department of Medicine , Western University , London , Canada.
authors.forename: Raymond
authors.initials: R
authors.lastname: Yee
authors.affiliation: a Division of Cardiology, Department of Medicine , Western University , London , Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Leong-Sit
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000494:pharmacology*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D019468:Disease Management; D006339:Heart Rate; D006801:Humans; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Atrial fibrillation; amiodarone; antiarrhythmic medications; digoxin; pulmonary vein ablation; rate control; rhythm control