Slee A, et al. - Researchers investigated the emergence of heart failure (HF) in atrial fibrillation (AF) patients undergoing different treatment strategies. From AFFIRM trial, they assessed 1,771 individuals (880 Rate, 891 Rhythm) with no history of HF, without clinical HF & normal left ventricular ejection fraction. Time to development of a composite of NYHA class ≥ II HF &/or cardiovascular death was reported in 21.4% of Rate and 16.8% of Rhythm individuals at 5 years. In AF pts. without HF, they observed symptomatic HF emergence more frequently with Rate control than with Rhythm control. Increased mortality risk was evident in correlation with HF appearance. Effective Rhythm control with documented sinus rhythm during > 75% of follow up visits as well as ventricular rate control was achieved in relation to delaying HF emergence.