Recommendations for Goals of Therapy With Rhythm Control

Referenced studies that support the recommendations are summarized in the Online Data Supplement.

COR	LOE	Recommendations
1	B-R	1. In patients with reduced LV function and persistent (or high burden) AF, a trial of rhythm control should be recommended to evaluate whether AF is contributing to the reduced LV function.1–6
2a	B-R	2. In patients with symptomatic AF, rhythm control can be useful to improve symptoms.7–11
2a	B-R	3. In patients with a recent diagnosis of AF (<1 year), rhythm control can be useful to reduce hospitalizations, stroke, and mortality.12–14
2a	B-R	4. In patients with AF and HF, rhythm control can be useful for improving symptoms and improving outcomes, such as mortality and hospitalizations for HF and ischemia.15–19
2a	B-NR	5. In patients with AF, rhythm-control strategies can be useful to reduce the likelihood of AF progression.20–27
2b	C-LD	6. In patients with AF where symptoms associated with AF are uncertain, a trial of rhythm control (eg, cardioversion or pharmacological therapy) may be useful to determine what if any symptoms are attributable to AF.28–32
2b	B-NR	7. In patients with AF, rhythm-control strategies may be useful to reduce the likelihood of development of dementia or worsening cardiac structural abnormalities.33–45