Prognostic Significance of Resting Heart Rate and Use of beta-Blockers in Atrial Fibrillation and Sinus Rhythm in Patients With Heart Failure and Reduced Ejection Fraction: Findings From the Swedish Heart Failure Registry
Journal article, 2015

BACKGROUND: In heart failure and reduced ejection fraction, the prognostic role of heart rate (HR) in atrial fibrillation (AF) is unknown and the effectiveness of beta-blockers has recently been questioned in AF. METHODS AND RESULTS: A total of 18 858 patients with heart failure and reduced ejection fraction registered with Swedish Heart Failure Registry were included in this study: patients with sinus rhythm (SR; n=11 466) and patients with AF (n=7392). The outcome measure was all-cause mortality. Compared with HR 100 beats per minute. However, in AF, the hazard ratio increased only for HR >100 beats per minute (1.30; P=0.001). beta-blocker use was associated with reduced mortality in SR (hazard ratio, 0.77; P=0.011) and in AF (hazard ratio, 0.71; P<0.001). For beta-blocker use in SR, the hazard ratio gradually increased with HR increment, whereas in AF, the hazard ratio significantly increased only for HR >100 beats per minute (1.29; P=0.003) compared with HR 100 beats per minute. beta-blocker use was associated with reduced mortality both in SR and in AF.

Aged

Middle Aged

Treatment Outcome

Heart Rate/drug effects/*physiology

Stroke Volume/*physiology

*Registries

Adrenergic beta-Antagonists/*therapeutic use

Heart Failure/complications/drug therapy/*physiopathology

Prognosis

Rest/*physiology

Aged

Humans

Male

Atrial Fibrillation/complications/drug therapy/*physiopathology

80 and over

Female

Author

S. J. Li

U. Sartipy

L. H. Lund

U. Dahlstrom

Martin Adiels

University of Gothenburg

Max Petzold

University of Gothenburg

Michael Fu

Circulation. Heart failure

1941-3289 (ISSN) 1941-3297 (eISSN)

Vol. 8 5 871-9

Subject Categories

Clinical Medicine

DOI

10.1161/CIRCHEARTFAILURE.115.002285

PubMed

26243796

More information

Created

10/10/2017