Lenient vs Strict Rate Control — EECC MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: A — A lenient rate control target of resting heart rate <110 bpm is acceptable in asymptomatic patients with preserved LVEF, based on the RACE II trial
The RACE II trial demonstrated that lenient rate control (resting HR <110 bpm) was non-inferior to strict rate control (resting HR <80 bpm) for a composite of CV death, HF hospitalisation, stroke, systemic embolism, bleeding, and life-threatening arrhythmias in permanent AF with preserved LV function. The 2024 ESC AF Guidelines recommend: lenient rate control (<110 bpm at rest) as an acceptable initial target for most patients (Class IIa). Stricter rate control may be needed for patients with: ongoing symptoms despite lenient control, HFrEF, or tachycardia-mediated cardiomyopathy. This patient at 95 bpm with preserved LVEF and no symptoms has adequate rate control.
Reference: ESC (2024): Guidelines for the Management of Atrial Fibrillation; RACE II Trial