NICE guidelines recommend beta blockers other than sotalol for rate control, as regular ongoing treatment.
I see the logic of giving them for frequent episodes of symptomatic adrenergic type AF (precipitated by anxiety, stress and exercise) with high heart rates. Also in combination with Flecainide to reduce proarrhythmic effect.
I'm not sure vagal AF (slow, asymptomatic, nocturnal after exercise or a meal) is considered often enough, and here beta blockers may be unhelpful.
For those of us with infrequent AF, or short-lived episodes or only mildly symptomatic, taking a beta blocker regularly often compromises our quality of life, possibly with no benefit.
Does anybody in this situation agree/disagree with my feeling that some GPs may simply follow NICE guidelines without thinking it through? Or perhaps the guidelines could be more comprehensive on this particular recommendation.
A rapid acting oral beta blocker as pip might be useful. Presumably they don't exist.
edit: I used to have vagal episodes of AF, now permanent AF/AFL