<P> There are two ways to approach atrial fibrillation using medications: rate control and rhythm control . Both methods have similar outcomes . Rate control lowers the heart rate closer to normal, usually 60 to 100 bpm, without trying to convert to a regular rhythm . Rhythm control tries to restore a normal heart rhythm in a process called cardioversion and maintains the normal rhythm with medications . Studies suggest that rhythm control is more important in the acute setting AF, whereas rate control is more important in the chronic phase . </P> <P> The risk of stroke appears to be lower with rate control versus attempted rhythm control, at least in those with heart failure . AF is associated with a reduced quality of life, and, while some studies indicate that rhythm control leads to a higher quality of life, some did not find a difference . </P> <P> A further study focused on rhythm control in people with AF with heart failure, based on the idea that AF increases mortality in this group . In this setting, rhythm control offered no advantage compared to rate control . </P> <P> In those with a fast ventricular response, intravenous magnesium significantly increases the chances of successful rate and rhythm control in the urgent setting without major side - effects . A person with poor vital signs, mental status changes, preexcitation, or chest pain often will go to immediate treatment with synchronized DC cardioversion . Otherwise the decision of rate control versus rhythm control using drugs is made . This is based on a number of criteria that includes whether or not symptoms persist with rate control . </P>

Atrial fibrillation is identified by all of the following except