Rate Control for Atrial Fibrillation

What is Rate Control?

Rate control is a drug treatment option that seeks to reduce the symptoms of atrial fibrillation (AF) by lowering the heart rate to less than 100 beats per minute. Rate control does not address the causes of atrial fibrillation and is not a cure for AF. Because rate control drug therapy does nothing to change the circumstances of occurrences of atrial fibrillation, the drug regimen is a lifelong treatment.

How Rate Control Works

Rate control medications prevent temporary circulatory instability. Your heart beats faster because of erratic electrical impulses in the atria. By slowing down the production of those impulses and blocking some conduction of those signals from the atria to the ventricles, your heart rate slows down. The objective is to accomplish a heart rate of less than 100 beats per minute.

Rate Control Medications

There are a few different types of rate control medications. Your physician will determine the most effective rate control medication based on your classification of atrial fibrillation and your medical history.

Beta Blockers

Reduce heart beats and blood pressure

Cardiac Glycosides

Also known as cardiac steroids, cardiac glycosides are naturally occurring drugs that improve cardiac output

Calcium Channel Blockers

Relax blood vessels, reducing the heart's workload

Rate control medications have a wide variety of side effects including fatigue, dizziness, impotence, depression, slow heart rate and shortness of breath. There are also toxicity issues with cardiac glycosides.^{⁵⁸^, ⁵⁹^, ⁶⁰}

Your doctor can help you decide what your treatment options are based upon the type of atrial fibrillation you have and your overall health and medical history. Take the time to educate yourself about your treatment options, write down questions to ask your doctor at your next follow-up, and speak to your physician about your options and concerns. If you are a patient or physician and are interested in learning additional information about clinical studies currently underway, please visit clinicaltrials.gov.

58. "Beta-adrenergic Blocking Agents (Systemic)." U.S. National Library of Medicine and the National Institutes of Health [Internet] © 2006 [cited 2007 Jan 25]. <http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202087.html>.
59. "Calcium Channel Blocking Agents (Systemic)." U.S. National Library of Medicine and the National Institutes of Health [Internet] © 2006 [cited 2007 Jan 25]. <http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202107.html>.
60. "Cardiac glycoside overdose." U.S. National Library of Medicine and the National Institutes of Health [Internet] © 2006 [cited 2007 Jan 25]. <http://www.nlm.nih.gov/medlineplus/ency/article/002581.htm>.