Harvard Heart Letter

Heart Beat: Some leniency on heart rate control in atrial fibrillation

Atrial fibrillation, the fast, erratic churning of the heart's upper chambers (the atria) can be treated two ways: by forcing the atria back into a steady rhythm, a strategy known as rhythm control, or by allowing the fibrillation to continue and instead controlling how fast the lower chambers of the heart (the ventricles) contract each minute, a strategy known as rate control. Both have their advantages and drawbacks, and are appropriate for different groups of people.

Although guidelines for rate control recommend keeping the heart rate under 80 beats per minute, a more lenient target of under 110 beats per minute may be just as effective and far easier to achieve, with fewer doctor visits or medication-related problems (New England Journal of Medicine, published online, March 15, 2010).

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