This department uses the best available scientiﬁc ﬁndings to offer practice guidance on a wide range of
conditions seen in primary care.The author, Alan Ehrlich, MD, is a deputy editor for DynaMed, Ipswich,
Mass., and assistant clinical professor in Family Medicine, University of Massachusetts Medical School in
Worcester. DynaMed (www.ebscohost.com/dynamed/) is a database that provides evidence-based infor-
mation on more than 3,000 clinical topics and is updated daily through systematic surveillance covering
more than 500 journals.The most important evidence identiﬁed is summarized here.
LENIENT RATE CONTROL Heart Association functional class. The authors
AND STRICT RATE CONTROL concluded that lenient rate control was as effec-
FOR ATRIAL FIBRILLATION tive as strict rate control for the prevention of
APPEAR TO HAVE SIMILAR major cardiovascular events.
Level 2: Mid-level evidence MODERATE ALCOHOL
Rate control and rhythm control strategies CONSUMPTION IN WOMEN MAY
have been associated with similar rates of stroke REDUCE RISK OF BECOMING
and death in patients with chronic atrial ﬁbril- OVERWEIGHT OR OBESE
lation (Arch Intern Med. 2005;165:258-262, Level 2: Mid-level evidence
available at archinte.ama-assn.org/cgi/content Moderate alcohol consumption has previously
/full/165/3/258, accessed April 14, 2010). A been associated with decreased cardiovascular risk
target heart rate of 60-80 beats/minute has (BMJ. 2006;332:1244-1248, available at www.
been suggested by the American College of bmj.com/cgi/content/full/332/7552/1244,
Cardiology (Circulation. 2006;114:e257-354, The desired accessed April 14, 2010) and decreased overall
available at circ.ahajournals.org/cgi/content rate control mortality (Arch Intern Med. 2006;166:2437-
/full/114/7/e257, accessed April 14, 2010), but 2445, available at archinte.ama-assn.org/cgi/
this recommendation is not