rytmekontrol

Rytmekontroll, or rhythm control, is a medical strategy aimed at restoring and maintaining a normal heart rhythm in patients with heart rhythm disorders, most commonly atrial fibrillation and atrial flutter. It is one of the main approaches to managing these conditions, alongside rate control, which focuses on limiting the ventricular rate without necessarily restoring sinus rhythm. The choice between rhythm and rate control depends on symptoms, comorbidity, patient preferences, and the likelihood of maintaining sinus rhythm.

Methods to achieve rytmekontroll include pharmacological and nonpharmacological options. Pharmacological approaches use antiarrhythmic drugs such as amiodarone, flecainide, propafenone, or sotalol. Nonpharmacological options include electrical cardioversion, which briefly applies a controlled shock to restore rhythm, and catheter ablation, often involving pulmonary vein isolation to prevent triggers of atrial fibrillation. Anticoagulation decisions around rhythm restoration follow stroke risk guidelines and the duration of atrial fibrillation.

Indications and considerations vary by patient. Rytmekontroll is often pursued in symptomatic individuals, those with new-onset or paroxysmal AF, or patients who prefer rhythm management for quality-of-life reasons. Efficacy depends on the underlying heart condition and treatment chosen; ablation can offer longer-term maintenance of sinus rhythm in many patients, particularly with paroxysmal AF, while antiarrhythmic drugs carry risks of toxicity and proarrhythmia. Ongoing monitoring and sometimes repeat procedures or therapy adjustments are common aspects of long-term rytmekontroll.