The Increasing Role of Rhythm Control in Patients With Atrial Fibrillation: JACC State-of-the-Art Review

A John Camm, Gerald V Naccarelli, Suneet Mittal, Harry J G M Crijns, Stefan H Hohnloser, Chang-Sheng Ma, Andrea Natale, Mintu P Turakhia, Paulus Kirchhof

Research output: Contribution to journalReview articleAcademicpeer-review


The considerable mortality and morbidity associated with atrial fibrillation (AF) pose a substantial burden on patients and health care services. Although the management of AF historically focused on decreasing AF recurrence, it evolved over time in favor of rate control. Recently, more emphasis has been placed on reducing adverse cardiovascular outcomes using rhythm control, generally by using safe and effective rhythm-control therapies (typically antiarrhythmic drugs and/or AF ablation). Evidence increasingly supports early rhythm control in patients with AF that has not become long-standing, but current clinical practice and guidelines do not yet fully reflect this change. Early rhythm control may effectively reduce irreversible atrial remodeling and prevent AF-related deaths, heart failure, and strokes in high-risk patients. It has the potential to halt progression and potentially save patients from years of symptomatic AF; therefore, it should be offered more widely.

Original languageEnglish
Pages (from-to)1932-1948
Number of pages17
JournalJournal of the American College of Cardiology
Issue number19
Publication statusPublished - 17 May 2022


  • Anti-Arrhythmia Agents/therapeutic use
  • Atrial Fibrillation/drug therapy
  • Atrial Remodeling
  • Catheter Ablation/adverse effects
  • Humans
  • Stroke/etiology
  • Treatment Outcome

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