Title: The Rhythm is Going to Get You: Rate vs Rhythm Treatment in Patients with Chronic Atrial Fibrillation
Faculty:
Kari Blackwell, PharmD, MHA
PGY1 Pharmacy Resident
Dell Seton Medical Center at the University of Texas
Disclosure: Dr. Blackwell does not have any relevant financial relationship(s) with ineligible companies
Learning Objectives:
- Recall guideline recommendations regarding rate and rhythm control of patients with AF
- Analyze available literature regarding which approach is the best long-term treatment for patients with atrial fibrillation
- Develop recommendations for which treatment would be best used in patients with AF
Gap:
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with both its incidence and prevalence continuing to rise in the United States and globally.1 Over time, the recommended treatment approach for AF has evolved. Prior to 2014, rhythm control was generally favored. However, the release of the 2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation marked a shift in clinical practice, recommending rate control as the initial strategy, with rhythm control reserved for cases in which rate control proved inadequate.
A decade later, the 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation revised this stance once more. Rather than designating a preferred strategy, the updated guideline emphasizes a patient-centered approach, recognizing that the choice between rate and rhythm control is nuanced and may evolve over time based on individual patient characteristics and clinical response.
It is essential that pharmacists are well-versed in current treatment recommendations for AF and are equipped to help identify the safest and most effective therapeutic strategy for each patient. This presentation will review the relevant literature and examine which patient populations may benefit most from initial treatment with either rate or rhythm control strategies.