in this article entitled, "Avoiding permanent atrial fibrillation: treatment approaches to prevent disease progression".
"AF is a progressive disease, and persistent or permanent AF is associated with greater patient morbidity and mortality than paroxysmal AF. Results from randomized controlled trials suggest no mortality benefit of a rhythm-control strategy for management of AF in comparison with a rate-control strategy. Nevertheless, use of a rate-control strategy is associated with more rapid progression of AF to persistent or permanent AF, partly due to morphological changes in the atria that facilitate maintenance of AF. Thus, for younger or highly symptomatic patients with AF, the benefits associated with a rhythm-control strategy should especially be considered and implemented as appropriate. In select patients, catheter ablation provides greater success for prevention of progression of AF than antiarrhythmic drug therapy, although a need for an individualized approach for rhythm control remains essential". From above article.
I wonder if my Atrial Fibrillation became so frequent because I was on Bisoprolol for over a year. Sotolol did not work for me either but then I only took it for a few days. Then when I saw my EP he put me on Amiodarone and weaned off the Bisoprolol which worked.