[Atrial fibrillation: rhythm vs. rate control]

The atrial fibrillation treatment has been controversial since almost a century. Several studies have been done and there is not a clear therapeutic strategy despite the new technological advances. The disyuntive persist between sinus rhythm control vs. ventricular rate control. The main studies like AFFIRM, RACE, PIAF, PAF2 and STAF have not shown a definitive strategy treatment. Recently, several subgroups have been stablished and variables like life quality and functional state have been included. New therapeutic strategies have resulted. Heart rate control is recommendable for asymptomatic 65 years old patients and older, whereas rhythm control is better for patients with severe symptoms.