<International Circulation>:Managing atrial fibrillation in chronic heart failure is always a hot topic. Are rhythm and rate control in chronic heart failure related to different clinical situations， and where do you stand on one versus the other?

 《国际循环》：慢性心力衰竭患者的房颤治疗一直是一个热点话题，节律控制和频率控制对于慢性心力衰竭患者在不同情况下意义有所不同，很多方面或许还需要进一步研究，您是否同意这一观点？

    Dr Adams: One of the most interesting things to come out of the atrial fibrillation literature is this apparent paradox that you can control the rate and leave the patient. The problem here might be the toxicity of older therapies. Older therapies really do carry a burden of adverse side effects and some of the more recent re-analyses of AFFIRM and some of the earlier trials of AFFIRM-HF have suggested that it is not so much sinus rhythm that is detrimental， it is that the drugs you prescribe to get them into sinus rhythm are problematic.
    Some of the newer agents appear to be less toxic and interestingly enough， although not as effective at maintaining sinus rhythm， are associated with improved outcomes. I see an explosion of interest in A