Is rate control better than rhythm control for atrial fibrillation in older high-risk patients?

Mortality with atrial fibrillation is similar with rhythm control and rate control treatment. However, adverse drug events and hospitalizations are more frequent with rhythm control therapy. Rate control therapy for atrial fibrillation should be the primary treatment strategy for an older high-risk population, but should not be extrapolated to younger and healthier patients (eg, patients with lone atrial fibrillation). These findings are consistent with another smaller study of patients with recurrent persistent atrial fibrillation.