Pitfalls in rate and rhythm control: Severe concomitant orthostatic hypotension unmasked after conversion to sinus rhythm

Transformation to atrial flutter may cause failure of rate control strategy even in previously stable patients with long time persistent atrial fibrillation. Spontaneous conversion to sinus rhythm can unmask orthostatic hypotension. Management of comorbid orthostatic hypotension might be challenging as it could be severe and have significant impact on patients' condition.