Heart rate and adverse outcomes in patients with prevalent atrial fibrillation.

Moschovitis, Giorgio; Johnson, Linda S B; Blum, Steffen; Aeschbacher, Stefanie; De Perna, Maria Luisa; Pagnamenta, Alberto; Mayer Melchiorre, Patrizia Assunta; Benz, Alexander P; Kobza, Richard; Di Valentino, Marcello; Zuern, Christine S; Auricchio, Angelo; Conte, Giulio; Rodondi, Nicolas; Blum, Manuel R; Beer, Juerg H; Kühne, Michael; Osswald, Stefan; Conen, David (2021). Heart rate and adverse outcomes in patients with prevalent atrial fibrillation. Open Heart, 8(1), e001606. B M J Group 10.1136/openhrt-2021-001606

[img]
Preview
Text
Moschovitis_OpenHeart_2021.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (423kB) | Preview

OBJECTIVE

The optimal target heart rate in patients with prevalent atrial fibrillation (AF) is not well defined. The aim of this study was to analyse the associations between heart rate and adverse outcomes in a large contemporary cohort of patients with prevalent AF.

METHODS

From two prospective cohort studies, we included stable AF outpatients who were in AF on the baseline ECG. The main outcome events assessed during prospective follow-up were heart failure hospitalisation, stroke or systemic embolism and death. The associations between heart rate and adverse outcomes were evaluated using multivariable Cox regression models.

RESULTS

The study population consisted of 1679 patients who had prevalent AF at baseline. Mean age was 74 years, and 24.6% were women. The mean heart rate on the baseline ECG was 78 (±19) beats per minute (bpm). The median follow-up was 3.9 years (IQR 2.2-5.0). Heart rate was not significantly associated with heart failure hospitalisation (adjusted HR (aHR) per 10 bpm increase, 1.00, 95% CI 0.94 to 1.07, p=0.95), stroke or systemic embolism (aHR 0.95, 95% CI 0.84 to 1.07, p=0.38) or death (aHR 1.02, 95% CI 0.95 to 1.09, p=0.66). There was no evidence of a threshold effect for heart rates <60 bpm or >100 bpm.

CONCLUSIONS

In this large contemporary cohort of outpatients with prevalent AF, we found no association between heart rate and adverse outcome events. These data are in line with recommendations that strict heart rate control is not needed in otherwise stable outpatients with AF.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Blum, Manuel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2053-3624

Publisher:

B M J Group

Funders:

[4] Swiss National Science Foundation ; [116] Swiss Heart Foundation = Schweizerische Herzstiftung

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

28 Apr 2021 19:34

Last Modified:

28 Apr 2021 21:05

Publisher DOI:

10.1136/openhrt-2021-001606

PubMed ID:

33883229

Uncontrolled Keywords:

atrial fibrillation heart failure stroke

BORIS DOI:

10.48350/156085

URI:

https://boris.unibe.ch/id/eprint/156085

Actions (login required)

Edit item Edit item
Provide Feedback