72
Management
7.1. Broad Considerations for Rate Control
COR LOE
Recommendations
1 B-NR 1. In patients with AF, SDM with the patient is recommended
to discuss rhythm- vs. rate-control strategies (taking into
consideration clinical presentation, comorbidity burden,
medication profile, and patient preferences), discuss therapeutic
options, and for assessing long-term benefits.
2a B-R 2. In patients with AF without HF who are candidates for select
rate-control strategies, heart rate target should be guided by
underlying patient symptoms, in general aiming at a resting
heart rate of <100 to 110 bpm.
7. Rate Control
Table 20. Clinical Presentations and Objectives of Heart
Rate Control
Presentation Objective
Symptomatic atrial fibrillation To reduce symptoms
Tachycardia-induced cardiomyopathy To improve heart function or reduce the
risk of recurrent cardiomyopathy
Implantable cardioverter-defibrillator use To reduce risk of inappropriate shock
Cardiac resynchronization therapy (CRT)
use
To enhance biventricular pacing (BiVP),
likelihood of myocardial recovery, and/or
preservation of function
Tachycardia-bradycardia form of sick sinus
syndrome among those with a pacemaker
To reduce the risk of hospitalization
