Control the heart rate (rate control)

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.

  • 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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