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Volume 359:1522 October 2, 2008 Number 14
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Rhythm Control versus Rate Control for Atrial Fibrillation

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by Roy, D.
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To the Editor: In their article on rhythm control as compared with rate control for atrial fibrillation, Roy et al. (June 19 issue)1 conclude that "rate control should be considered a primary approach for patients with atrial fibrillation and congestive heart failure." We believe this conclusion may be overstated because of some limitations that have not been emphasized. First, a significant proportion of patients in the rate-control group crossed over to the rhythm-control group because of worsening heart failure. Outcomes in this particular group would be of interest, since this condition is associated with a worse prognosis.2 Second, at 12 . . . [Full Text of this Article]



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