Rate-control or rhythm-control: Where do we stand?

L. Testa, G. Trotta, A. Dello Russo, M. Casella, G. Pelargonio, F. Andreotti, F. Bellocci

Research output: Contribution to journalArticlepeer-review


Atrial fibrillation is the most common sustained rhythm disturbance and its prevalence is increasing worldwide due to the progressive aging of the population. Current guidelines clearly depict the gold standard management of acute symptomatic atrial fibrillation but the best-long term approach for first or recurrent atrial fibrillation is still debated with regard to quality of life, risk of new hospitalizations, and possible disabling complications, such as thromboembolic stroke, major bleeds and death. Some authors propose that regaining sinus rhythm in all cases, thus re-establishing a physiologic cardiac function not a prolonged antithrombotic, therapy, avoids the threat of intracranial or extracranial haemorrhages due to Vitamin K antagonist or aspirin. On the contrary, aadvocates of a rate control approach with an accurate antithrombotic prophylaxis propose that such a strategy may avoid the risk of cardiovascular and non cardiovascular side effects related to antiarrhythmic drugs. This review aims to explore the state of our knowledge in order to summarize evidences and issues that need to be furthermore clarified.

Original languageEnglish
Pages (from-to)296-304
Number of pages9
JournalIndian Pacing and Electrophysiology Journal
Issue number4
Publication statusPublished - Oct 2005


  • Atrial fibrillation
  • Rate control
  • Rhythm control
  • Secondary prevention

ASJC Scopus subject areas

  • Medicine(all)


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