Rhythm control strategies have not shown to be superior to rate control strategies and can lead to adverse effects and higher rates of hospital admissions. There is an excessive use of rhythm control strategies in clinical practice. Rhythm control should be used in cases of poor rate control, young patients or with low risk of recurrence of AF and the presence of AF caused by a reversible process. Adverse effects of antiarrhythmic agents, careful selection of the adequate drug and candidates for ablation should be considered. Rhythm or rate management strategies can be complementary. The most important aims include appropriate management of the underlying disease, symptom management, prevention of thromboembolism and the development of AF.