Rhythm control procedures are selectively applied and vary by demographic and clinical factors, according to a retrospective cross-sectional study of patients in Auckland with atrial fibrillation or flutter. A total of 1908 patients (46.8% female) were identified up to 31 August 2021, of whom 15.3% underwent rhythm control procedures. Increased age and female sex were associated with a lower chance of receiving rhythm control procedures (adjusted OR per year 0.96 [95% CI 0.95-0.97] and 0.46 [95% CI 0.34-0.63], respectively). Compared with European patients, Māori, Pacific peoples and patients of other ethnicities were less likely to undergo rhythm control procedures (aOR 0.52 [95% CI 0.36-0.77], 0.41 [95% CI 0.28-0.60] and 0.47 [95% CI 0.28-0.79], respectively).