Heart Rate Control in Paroxysmal Atrial Fibrillation
Clinical Scenario
Paroxysmal AF is an episode of atrial fibrillation that terminates spontaneously within 7 days, or with the assistance of an intervention. Despite its self-limiting course, effective rate management remains a defined clinical priority.
Treatment Approach
Rate control with a single pharmacological agent is the recommended approach, with agent selection guided by left ventricular function.
Full agent selection criteria, dosing framework, and escalation guidance are in the structured regimen.
Clinical Target
Resting heart rate <110 b.p.m.
Lenient rate control is the initial target. Stricter control is considered for patients with continuing AF-related symptoms.
References
DOI: 10.1093/eurheartj/ehae176
AF which terminates spontaneously within 7 days or with the assistance of an intervention.
Beta-blockers and/or digoxin are recommended in patients with AF and LVEF ≤40% to control heart rate and reduce symptoms.
Beta-blockers, diltiazem, verapamil, or digoxin are recommended as first-choice drugs in patients with AF and LVEF >40% to control heart rate and reduce symptoms.
Lenient rate control with a resting heart rate of < 110 b.p.m. should be considered as the initial target for patients with AF, with stricter control reserved for those with continuing AF-related symptoms.
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