High heart rates during paroxysmal atrial fibrillation: continuous rhythm monitoring data of the RACE V study.

IF 5.1 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Pub Date : 2024-10-10 DOI:10.1136/heartjnl-2024-324376

Tim Koldenhof, Isabelle C Van Gelder, Martijn E van de Lande, Meelad I H Al-Jazairi, Robert G Tieleman, Michiel Rienstra

{"title":"High heart rates during paroxysmal atrial fibrillation: continuous rhythm monitoring data of the RACE V study.","authors":"Tim Koldenhof, Isabelle C Van Gelder, Martijn E van de Lande, Meelad I H Al-Jazairi, Robert G Tieleman, Michiel Rienstra","doi":"10.1136/heartjnl-2024-324376","DOIUrl":null,"url":null,"abstract":"Background: Preventing high heart rates in patients with atrial fibrillation (AF) is a key objective of AF management. Data regarding heart rates in patients with paroxysmal AF (PAF) is lacking. This analysis aimed to provide insight into heart rates during PAF episodes measured with continuous implantable loop monitoring.Methods: In present analysis of the Interaction between hyperCoagulability, Electrical remodeling, and Vascular Destabilization in the Progression of AF study, we included 349 patients with at least one year of continuous rhythm monitoring and an episode of AF. Mean heart rates and duration of AF episodes were used to calculate total AF duration and AF duration above different heart rate cut-offs.Results: The median age was 64.0 (58.4 to 70.5) years, 152 (44%) were women and CHA2DS2-VASc score ≥2 or higher in 255 (73%) patients. During 28.3 (21.3 to 35.0) months of follow-up, the median number of AF episodes was 62 (12 to 293) with a median total AF duration of 4.6 (0.8 to 26.8) days. At baseline, 172 (49%) patients used beta-blockers, 64 (18%) used diltiazem or verapamil and 5 (1%) used digoxin. A total of 133 patients (38%) experienced a heart rate >110 bpm for more than 50% of the time during AF. Fifty-six (16%) patients had a heart rate >130 bpm for more than 50% of the time while in AF. During follow-up, 39 patients (11%) received an increase of rate-controlling medication.Conclusion: Continuous rhythm monitoring revealed that more than a third of PAF patients had heart rates above 110 bpm for more than half of their time in AF.Trial registration number: Clinicaltrials.gov identifier NCT02726698.","PeriodicalId":12835,"journal":{"name":"Heart","volume":null,"pages":null},"PeriodicalIF":5.1000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/heartjnl-2024-324376","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Preventing high heart rates in patients with atrial fibrillation (AF) is a key objective of AF management. Data regarding heart rates in patients with paroxysmal AF (PAF) is lacking. This analysis aimed to provide insight into heart rates during PAF episodes measured with continuous implantable loop monitoring.

Methods: In present analysis of the Interaction between hyperCoagulability, Electrical remodeling, and Vascular Destabilization in the Progression of AF study, we included 349 patients with at least one year of continuous rhythm monitoring and an episode of AF. Mean heart rates and duration of AF episodes were used to calculate total AF duration and AF duration above different heart rate cut-offs.

Results: The median age was 64.0 (58.4 to 70.5) years, 152 (44%) were women and CHA₂DS₂-VASc score ≥2 or higher in 255 (73%) patients. During 28.3 (21.3 to 35.0) months of follow-up, the median number of AF episodes was 62 (12 to 293) with a median total AF duration of 4.6 (0.8 to 26.8) days. At baseline, 172 (49%) patients used beta-blockers, 64 (18%) used diltiazem or verapamil and 5 (1%) used digoxin. A total of 133 patients (38%) experienced a heart rate >110 bpm for more than 50% of the time during AF. Fifty-six (16%) patients had a heart rate >130 bpm for more than 50% of the time while in AF. During follow-up, 39 patients (11%) received an increase of rate-controlling medication.

Conclusion: Continuous rhythm monitoring revealed that more than a third of PAF patients had heart rates above 110 bpm for more than half of their time in AF.

Trial registration number: Clinicaltrials.gov identifier NCT02726698.

查看原文本刊更多论文

阵发性心房颤动时的高心率：RACE V 研究的连续心律监测数据。

背景：防止心房颤动（房颤）患者出现高心率是房颤治疗的一个关键目标。有关阵发性房颤（PAF）患者心率的数据还很缺乏。本分析旨在深入了解通过连续植入式环路监测仪测量的阵发性房颤发作时的心率：在目前的 "房颤进展过程中高凝状态、电重塑和血管不稳定之间的相互作用 "分析研究中，我们纳入了 349 名至少接受过一年连续心律监测并发作过房颤的患者。用平均心率和房颤发作持续时间计算总房颤持续时间和超过不同心率临界值的房颤持续时间：中位年龄为 64.0（58.4 至 70.5）岁，152 人（44%）为女性，255 人（73%）的 CHA2DS2-VASc 评分≥2 或更高。在 28.3（21.3 至 35.0）个月的随访期间，房颤发作次数中位数为 62（12 至 293）次，房颤总持续时间中位数为 4.6（0.8 至 26.8）天。基线时，172 名患者（49%）使用β-受体阻滞剂，64 名患者（18%）使用地尔硫卓或维拉帕米，5 名患者（1%）使用地高辛。共有 133 名患者（38%）在房颤期间有 50% 以上的时间心率大于 110 bpm。56名患者（16%）在房颤期间有超过50%的时间心率>130 bpm。在随访期间，39 名患者（11%）接受了增加心率控制药物的治疗：结论：连续心律监测显示，超过三分之一的 PAF 患者在房颤期间有一半以上的时间心率超过 110 bpm：试验注册号：Clinicaltrials.gov 识别码 NCT02726698。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Heart 医学-心血管系统

CiteScore

10.30

自引率

5.30%

发文量

320

审稿时长

3-6 weeks

期刊介绍： Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.