Rate control was more cost-effective than rhythm control in persistent atrial fibrillation.

Intervention: rate control (n = 256) or rhythm control (n = 266). Rate control included use of digitalis, a non-dihydropyridine calcium channel blocker, and a b blocker, alone or in combination. Target resting heart rate was ,100 beats/minute. Patients in the rhythm control group received serial electrical cardioversion and serial antiarrhythmic drugs using sotalol, 160– 320 mg/day, as the first choice, followed by class IC antiarrhythmic drugs, with amiodarone used as the last choice.