Atrial Fibrillation in Heart Failure: Rate or Rhythm Control Strategy

Atrial fibrillation and heart failure are intimately related as they shared the same risk factors, unsurprisingly they commonly coexist and complicate each other. Management of atrial fibrillation in heart failure is usually simplified into rate or rhythm control strategy, as each offers its advantages and limitations. Pharmacological rate and rhythm control strategy has been compared for the last decades; however, as more nonpharmacological approach raised as viable option has driven the management strategy discussion even further. On the other hand, heart failure understanding is also evolving and more detailed classification has been made based on left ventricular function. Justification for rate or rhythm control strategy should be individualized predicated on clinical phenotype. Moreover, the chosen strategy should be flexible and can be adjusted if the preferred strategy is ineffective.