Controlling heart rate, rather than heart rhythm, leads to a better outcome for people with atrial fibrillation.

Around two million people in the United States, many of them elderly, suffer from atrial fibrillation (AF), a condition in which the heart beats rapidly and irregularly. The heart is unable to pump properly and clots may form, as blood pools inside the heart. This, in turn, risks stroke and other problems.

The traditional approach to AF is to give drugs, such as amiodarone, which bring the rhythm back to normal. A secondary approach, which is less common, is to use drugs such as beta blockers, that control heart rate. A new study, led by researchers at the University of Calgary, Canada, compares rhythm control and rate control for the first time. They find that there is little difference in the death rate between groups of patients treated by either approach. But those receiving rhythm control drugs are more likely to experience side effects and have a higher rate of hospitalization. The drugs used to control heart rate are also less expensive than those which target the heart's rhythm. Therefore, it may be more economic, and better for the patient, to shift the emphasis toward control of heart rate in AF.

Source

New England Journal of Medicine 5th December 2002