Heart rate and atrial fibrillation/flutter in HFmrEF/HFpEF: a participant-level analysis across five randomized clinical trials - PubMed
8 hours ago
- #Heart Failure
- #Atrial Fibrillation
- #Heart Rate
- Elevated heart rate is a known risk marker in heart failure (HF), but its prognostic relevance in patients with atrial fibrillation/flutter (AFF) is less clear.
- A participant-level pooled analysis of five HFmrEF/HFpEF clinical trials (CHARM-Preserved, I-PRESERVE, TOPCAT-Americas, PARAGON-HF, DELIVER) was conducted.
- 29% of participants (5,816 out of 19,975) had AFF on baseline ECG, showing higher baseline heart rates (75 vs. 68 bpm) and increased risk for CV death or HF hospitalization.
- Patients in sinus rhythm had higher event rates with increasing heart rates, while those with AFF showed similar event rates across heart rate ranges.
- The relationship between heart rate and outcomes was not influenced by β-blocker use.
- Optimal management of AFF in HFmrEF/HFpEF requires further dedicated study.