Pharmacologic Rhythm Control versus Rate Control in Heart Failure and Atrial Fibrillation

Heart failure (HF) with atrial fibrillation (AF) is correlated with worse prognosis requiring special approach.Rate control has been the first line of treatment in cases of HF and HF. On the other hand, rhythm controlhas been proven to be effective in returning sinus rhythm resulting in better prognosis for patients with HFbut not HF. Its role in cocurring cases of HF and AF is not fully understood. Thus, this study aims to analysewhether pharmacologic rhythm control can be applied to cases of HF and AF to reduce mortality. A searchwas conducted via PubMed, Medline, ProQuest, and Cochrane Database on January 2016. One study wasselected after filtering process by inclusion and exclusion criteria and critical appraisal was performed. It wasfound that there was rhythm control and rate control do no have favouring effect towards mortality shown byRR 1.03 (95% CI 0.90-1.17, p=0.69). Rate control has protective effect towards hospitalizations by RR of 0.92(95% CI 0.86 – 0.98, p=0.008, NNT=19). To conclude, rhythm control is not superior to rate control in reducingmortality and rate control should be still be considered as first line treatment of HF and AF