Long-term ventricular rate control in patients with atrial fibrillation without heart failure

* In such patients, beta blockers can decrease mortality and other adverse cardiac events.

¶ Chronic bronchospastic disease refers to conditions like chronic obstructive pulmonary disease and asthma.

Δ The choice of drug should be based on patient factors. For patients who are intolerant of the initial drug, it is reasonable to switch to the other category.

◊ If the patient has chronic bronchospastic disease, they may not tolerate being on a beta blocker. In such patients, it is prudent to perform a trial of beta blockers with close follow-up in order to monitor for side effects.

§ Refer to UpToDate content for doses and monitoring.

¥ For choice of specific agents, refer to UpToDate content on pharmacologic rate control of atrial fibrillation.

‡ The optimal ventricular rate goal for patients with atrial fibrillation has not been determined. A reasonable goal is to achieve a resting rate ≤80 beats/min and ≤110 beats/min during moderate exercise (such as with the six-minute walk).