articleNew England Journal of MedicineMar 15, 2010Closed access

Lenient versus Strict Rate Control in Patients with Atrial Fibrillation

Netherlands Heart Institute · University Medical Center Groningen · +12 more institutions

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Abstract

Background

Rate control is often the therapy of choice for atrial fibrillation. Guidelines recommend strict rate control, but this is not based on clinical evidence. We hypothesized that lenient rate control is not inferior to strict rate control for preventing cardiovascular morbidity and mortality in patients with permanent atrial fibrillation.

Methods

We randomly assigned 614 patients with permanent atrial fibrillation to undergo a lenient rate-control strategy (resting heart rate

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