Atrial fibrillation: slow the rate, or bring back the rhythm?
Rate control lets the atria keep fibrillating and slows the ventricles. Rhythm control restores sinus rhythm — and digoxin can’t do that.
Select any card for the reasoning, what to watch for and an exam tip.
What the two strategies aim for
Rhythm control aims to get back the top strip. Rate control accepts the bottom one, but slows it down.
Sinus rhythm
Atrial fibrillation
Swipe along the strip →
vs
Rate control
Leave the atria fibrillating; slow the ventricles
Rhythm control
Restore sinus rhythm, then keep it
Key takeaway
Rate control is first-line for most: a beta-blocker, diltiazem or verapamil, or digoxin. Rhythm control uses flecainide, amiodarone or electrical cardioversion. Whichever you choose, assess the stroke risk.
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