For patients with paroxysmal atrial fibrillation (AF), either rate control or rhythm control is considered an acceptable strategy. Primary care and general practitioners are less often aware of the decision-making and medications involved in maintenance of rhythm control vs rate for patients with AF. However, it is important to know when and how to maintain rhythm control for those patients in whom this is the preferred option. Test your own knowledge here!
Question 1. When should rhythm control for AF be pursued over rate control?
A. In all patients with reduced LVEF (< 40%).
B. When a patient remains symptomatic despite adequate rate control.
C. When the patient has a strong preference for rhythm control.
D. When risk of toxicity or side effects from antiarrhythmic medication is low.
E. When there is a high thromboembolic risk (as determined by CHA2DS2-Vasc score).