The treatment approaches for a patient with AFib have been updated in the most recent ACC/AHA/ESC (European Society of Cardiology)/HRS Guidelines. ^[23] In the left-hand column of the Figure are listed the major findings regarding pharmacotherapy to achieve rate control versus rhythm control (restoration of sinus rhythm).  These therapeutic approaches will be discussed in subsequent presentations, but the important point is that stroke risks were higher in rhythm control patients than the rate control patients in each of the rate versus rhythm control trials, largely because anticoagulation was stopped by physicians who believed sinus rhythm would remove the risk. [24] [25] [26] [27] [28] On the right in the Figure, the major constraints of cardioversion and ablation of the fibrillation foci are shown; here too the data suggest that risk of stroke persists, despite the restoration of sinus rhythm with cardioversion, or successful pulmonary vein isolation or surgical ablation.^{[23, 27-28]}

Reiffel JA. Am J Med 2013; 126: 00-00.