Hagens et al identified factors affecting the quality of life for patients treated for persistent atrial fibrillation. These can help to identify patients who may benefit from more aggressive management. The authors are from University Hospital Groningen, Free University Medical Center (Amsterdam), St. Antonius Hospital (Nieuwegein), University Hospital Maastricht in The Netherlands. The authors are participants in the RACE (rate control versus electrical cardioversion for persistent atrial fibrillation) study.