The therapeutic approach to paroxysmal or persistent atrial fibrillation: rhythm control versus rate control. A review.

Atrial fibrillation (AFib) is the commonest form of arrhythmia in patients with or without cardiac disease. There is still controversy concerning the best treatment for paroxysmal or persistent atrial fibrillation: rhythm control (conversion of AFib to sinus rhythm) or rate control (control of ventricular rate with maintenance of AFib). This review aims to discuss the best evidence available on the initial approach to paroxysmal or persistent AFib. We found four major articles, whose results failed to prove the superiority of one approach over the other. However, there was a non-statistically significant tendency in favor of rate control in a set of clinically important results. Based on this data, we recommend rate control as the first approach to paroxysmal or persistent AFib.