Heart rate control is an important part of atrial fibrillation (AF) treatment and the recommendation for the target rate has become lenient in the recent guideline. Since heart rhythm of AF patients is irregularly irregular with great rate variation, the number of effective ventricular contractions may be different within a given time period among patients with similar heart rates and it may further lead to different levels of cardiac output. Therefore, we propose that every AF patient has his (her) own optimal heart rate, or to say that, the target for rate control in each AF patient should be individualized. This optimal heart rate can be defined by pulse counting, echocardiography or cardiopulmonary exercise test. With this new target, patients will achieve higher cardiac output with better exercise tolerance and life quality, even an improved prognosis.
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