In patients with atrial fibrillation (AF), the ventricular rate is controlled by the conduction properties of the atrioventricular (AV) node. In the typical patient with untreated AF, the ventricular rate can reach 150 beats/min or higher.
There are two important reasons to prevent a rapid ventricular response in patients with AF:
●Avoidance of hemodynamic instability and/or symptoms. (See "Hemodynamic consequences of atrial fibrillation and cardioversion to sinus rhythm".)
●Avoidance of a tachycardia-mediated cardiomyopathy. (See "Tachycardia-mediated cardiomyopathy".)
The use of pharmacologic therapies to achieve rate control in AF will be reviewed here. Nonpharmacologic therapies for rate control in AF are discussed separately. (See "Control of ventricular rate in atrial fibrillation: Nonpharmacologic therapy".)