Atrial fibrillation is the most common cardiac arrhythmia. The main objective of our study is to compare between the two strategies of atrial fibrillation management which are restoration and maintenance of sinus rhythm or heart rate control with permanent anticoagulation regarding composite endpoint, quality of life, cost of therapy over one year of follow up. The study consisted of 84 patients, 43 patients in the rhythm control group and 41 patients in the rate control group. There was no significant difference between the two groups at the time of randomization and during one year of follow up. Patients in the rate group showed more frequent heart failure than patients in the rhythm group.