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Rate control means you and your doctor have agreed to accept atrial fibrillation as condition, but you may have to control the rate of the heart (beats per minute) to avoid symptoms.
Controlling the heart rate is the treatment option when your doctor was unable to restore normal rhythm (unsuccessful attempt), or the doctor considers that because of your underlying heart condition, restoring the normal sinus rhythm is almost impossible.
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With medication
Your doctor may prescribe medication to normalise your heart rate (70-110 beats per minute at rest).
Depending on your symptoms the doctor may choose strict rate control (keeping the heart rate around 70-90 beats per minute at rest) or lenient rate control (keeping the heart rate around 100-110 beats per minute at rest).
Medications that can be used to control your heart rate are:
- Beta blockers: These medications slow the heart rate at rest as well as during activity. They are usually the first choice regardless of underlying heart disease.
- Calcium channel blockers: These medications also control your heart rate, but may need to be avoided if you have heart failure or low blood pressure.
- Digoxin: This drug controls the heart rate at rest, but not during activity. It can be added to beta blockers or less frequently to calcium channel blockers if a single therapy didn’t slow the heart rate enough.
- Amiodarone: In very rare situations your doctor may decide to control your heart rate with this drug alone, or in addition to beta blockers. Amiodarone is very effective at controlling heart rate, but has serious side effects in chronic therapy. It accumulates in your thyroid gland, in your lungs, skin etc.
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FREQUENTLY ASKED QUESTIONS
Why is heart rate control important in AFib?
Controlling the heart rate prevents symptoms and reduces the risk of heart failure.
What medications are used for heart rate control in AFib?
Beta-blockers, calcium channel blockers, and digoxin are commonly used.
Can heart rate control cure AFib?
No, rate control manages symptoms but does not address the underlying arrhythmia.
What is a target heart rate for AFib patients?
A resting heart rate of 60–100 beats per minute is generally considered ideal.
Can exercise worsen heart rate in AFib?
Intense exercise may increase heart rate, but moderate activity is usually safe and beneficial.
Is rate control always sufficient for managing AFib?
No, the vast majority of patients will benefit more from rhythm control, although heart rate control may be sufficient in selected patients
