Which class is commonly used for rate control in atrial fibrillation?

• A. Digoxin
• B. ACE inhibitors
• C. Beta-blockers
• D. Statins

Answer: (C)

Controlling the ventricular rate in atrial fibrillation relies on slowing conduction through the atrioventricular (AV) node. Beta-blockers achieve this by blocking sympathetic input to the AV node, which reduces AV nodal conduction and allows more time for the ventricles to fill, thereby lowering the heart rate. This makes beta-blockers a common first-line choice for rate control, effective both at rest and during activity and helpful in improving symptoms and hemodynamics.

Digoxin can be used for rate control, particularly in sedentary patients or those with heart failure with reduced ejection fraction, but it is less reliable during exercise or high sympathetic states, so it isn’t as broadly chosen as the primary agent. ACE inhibitors or ARBs and statins address blood pressure, heart failure risk, or lipid management, but they don’t directly slow AV nodal conduction for rate control in AF.