77
Figure 18. AF Long-Term Rate Control
Beta blockers
or NDCC
(1)
Beta blockers
(1)
NDCC
(Diltiazem,
Verapamil)
(3: Harm)
LVEF >40%
Digoxin
(2a)
Digoxin
(2a)
LVEF ≤40%
Long-term rate
control
Dronedarone
(3: Harm)
Permanent AF
7.2.2. Long-Term Rate Control
COR LOE
Recommendations
2a B-R 3. In patients with AF and HF symptoms, digoxin is reasonable
for long-term rate control in combination with other rate-
controlling agents, or as monotherapy if other agents are not
preferred, not tolerated, or contraindicated.
3: Harm C-LD 4. In patients with AF and left ventricular ejection fraction
(LVEF) <40%, nondihydropyridine calcium channel-blocking
drugs should not be administered given their potential to
exacerbate HF.
3: Harm B-R 5. In patients with permanent AF who have risk factors for
cardiovascular events, dronedarone should not be used for
long-term rate control.
(cont'd)
