Kotecha D, Bunting KV, Gill SK, et al. - Researchers undertook this randomized, open-label, blinded end-point clinical trial to investigate whether patient-reported quality of life differs among patients with permanent atrial fibrillation (defined as no plan to restore sinus rhythm) and symptoms of heart failure who received treatment with digoxin or bisoprolol (a β-blocker) for heart rate control. Digoxin (n = 80; dose range, 62.5-250 μg/d; mean dose, 161 μg/d) or bisoprolol (n = 80; dose range, 1.25-15 mg/d; mean dose, 3.2 mg/d) was received by patients (n = 160) aged 60 years or older with permanent atrial fibrillation and dyspnea classified as New York Heart Association class II or greater. For the digoxin group vs for the bisoprolol group, the mean 36-Item Short Form Health Survey physical component summary scores (higher scores are better) were 31.5 vs 29.3, respectively, at 6 months, which was not statistically significant. Quality of life at 6 months did not differ significantly between low-dose digoxin or bisoprolol groups among patients with permanent atrial fibrillation and symptoms of heart failure. These data lend support to potentially basing decisions regarding treatment on other end points.