Adequate heart rate control
In this study, patients qualified to rhythm control were more likely to have HR inadequately controlled (<50 or > 110 bpm) than patients with rate control. Importantly, the majority of patients with suboptimally controlled HR in both groups remained highly symptomatic (EHRA II-IV). According to guidelines, lenient rate control is indicated as an initial approach, unless symptoms require stricter rate control [2]. Importantly, an attempt should be made to improve physician’ skills to successfully deliver symptom-focused management.