The authors conclude that in patients with persistent atrial fibrillation, or with atrial fibrillation that is likely to reoccur, rate control in combination with anticoagulation seems to be comparable with attempting to maintain sinus rhythm. They add that the rhythm-control strategy may be indicated in selected patients, although it should not be the preferred strategy in all patients with atrial fibrillation.

KARL E. MILLER, M.D.

De Denus S, et al. Rate vs rhythm control in patients with atrial fibrillation: a meta-analysis. Arch Intern Med February 14, 2005;165:258-62.