Physicians' Academy for Cardiovascular Education
Reducing heart rate benefits HF patients in sinus rhythm, but not those with AF

Reducing heart rate benefits HF patients in sinus rhythm, but not those with AF

News - Apr. 30, 2017

Paris, France | Targeting heart rate to improve mortality in heart failure with reduced ejection fraction: a comparison of sinus rhythm and atrial fibrillation

Presented at ESC Heart Failure 2017 by John CLELAND (London, United Kingdom), on behalf of the Beta-blockers in Heart Failure Collaborative Group

Main results

Conclusion

Thus, these pooled data show that higher baseline heart rate is associated with higher mortality in sinus rhythm, but makes no difference in AF. A higher dose of betablocker (and of placebo!) is associated with lower mortality in sinus rhythm, and a lower attained heart rate is associated with lower mortality in sinus rhythm, but does not affect mortality in AF.

Heart rate turned out not to be a good predictor of response to treatment with a betablocker, as efficacy was similar in all heart rate categories. Thus, Dr. Cleland concluded that in clinical practice, it is important to not only attain the proper dose of betablocker, but also to lower heart rate, possibly with an additional agent. In AF, there is little evidence to expect a benefit.

Disclosures

Our coverage of ESC HF 2017 is based on the information provided during the congress.

The data have been published in J Am Coll Cardiol

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