Ventricular rate in atrial fibrillation and the risk of heart failure and death
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Ventricular rate in atrial fibrillation and the risk of heart failure and death. / Westergaard, Lucas Malta; Alhakak, Amna; Rørth, Rasmus; Fosbøl, Emil L.; Kristensen, Søren L.; Svendsen, Jesper H.; Graff, Claus; Nielsen, Jonas B.; Gislason, Gunnar H.; Kober, Lars; Torp-Pedersen, Christian; Lee, Christina J. Y.; Weeke, Peter E.
In: Europace, Vol. 25, No. 5, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Ventricular rate in atrial fibrillation and the risk of heart failure and death
AU - Westergaard, Lucas Malta
AU - Alhakak, Amna
AU - Rørth, Rasmus
AU - Fosbøl, Emil L.
AU - Kristensen, Søren L.
AU - Svendsen, Jesper H.
AU - Graff, Claus
AU - Nielsen, Jonas B.
AU - Gislason, Gunnar H.
AU - Kober, Lars
AU - Torp-Pedersen, Christian
AU - Lee, Christina J. Y.
AU - Weeke, Peter E.
PY - 2023
Y1 - 2023
N2 - Aims While clinical trials have suggested that a high ventricular rate is associated with increased risk of heart failure (HF) and mortality, all-comers studies are warranted. Objective To assess 1-year risk of new-onset diagnosed HF and all-cause mortality among rate-control treated patients presenting with atrial fibrillation (AF) on an electrocardiogram (ECG) according to ventricular rate. Methods and results ECGs recorded at the Copenhagen General Practitioners Laboratory (2001-15) were used to identify patients with AF. Multivariate Cox proportional hazard regression models were used to compare risk of new-onset HF and all-cause mortality after first ECG presenting with AF according to ventricular rate on ECG [ 110 beats per minute (bpm)]. We identified 7408 patients in treatment with rate control drugs at time of first ECG presenting with AF [median age 78 years (Q1,Q3 = 70-85 years)], 45.8% male, median ventricular rate 83 bpm, (Q1,Q3 = 71-101 bpm)]. During 1-year follow-up, 666 (9.0%) of all patients with AF developed HF and 858 (11.6%) died. Patients with AF ventricular rates 100-110 bpm and >110 bpm had a hazard ratio (HR) of 1.46 (CI: 1.10-1.95) and 2.41 (CI: 1.94-3.00) respectively for new-onset HF, compared with 60-79 bpm. Similarly, patients with AF ventricular rates 100-110 bpm and >110 bpm had a HR of 1.44 (CI: 1.13-1.82) and 1.34 (CI: 1.08-1.65) respectively for all-cause mortality, compared with 60-79 bpm. Conclusions Ventricular rates >= 100 bpm among patients presenting with AF on ECG in treatment with rate control drugs were associated with greater risk of both new-onset HF and all-cause mortality.
AB - Aims While clinical trials have suggested that a high ventricular rate is associated with increased risk of heart failure (HF) and mortality, all-comers studies are warranted. Objective To assess 1-year risk of new-onset diagnosed HF and all-cause mortality among rate-control treated patients presenting with atrial fibrillation (AF) on an electrocardiogram (ECG) according to ventricular rate. Methods and results ECGs recorded at the Copenhagen General Practitioners Laboratory (2001-15) were used to identify patients with AF. Multivariate Cox proportional hazard regression models were used to compare risk of new-onset HF and all-cause mortality after first ECG presenting with AF according to ventricular rate on ECG [ 110 beats per minute (bpm)]. We identified 7408 patients in treatment with rate control drugs at time of first ECG presenting with AF [median age 78 years (Q1,Q3 = 70-85 years)], 45.8% male, median ventricular rate 83 bpm, (Q1,Q3 = 71-101 bpm)]. During 1-year follow-up, 666 (9.0%) of all patients with AF developed HF and 858 (11.6%) died. Patients with AF ventricular rates 100-110 bpm and >110 bpm had a hazard ratio (HR) of 1.46 (CI: 1.10-1.95) and 2.41 (CI: 1.94-3.00) respectively for new-onset HF, compared with 60-79 bpm. Similarly, patients with AF ventricular rates 100-110 bpm and >110 bpm had a HR of 1.44 (CI: 1.13-1.82) and 1.34 (CI: 1.08-1.65) respectively for all-cause mortality, compared with 60-79 bpm. Conclusions Ventricular rates >= 100 bpm among patients presenting with AF on ECG in treatment with rate control drugs were associated with greater risk of both new-onset HF and all-cause mortality.
KW - Atrial fibrillation
KW - Atrial flutter
KW - Rate-control
KW - Heart failure
KW - Mortality
U2 - 10.1093/europace/euad088
DO - 10.1093/europace/euad088
M3 - Journal article
C2 - 37083042
VL - 25
JO - Europace
JF - Europace
SN - 1099-5129
IS - 5
ER -
ID: 346198809