Department of Cardiology, National Hospital Organization Kyoto Medical Center.
Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine.
Circ J. 2020 Nov 25;84(12):2138-2147. doi: 10.1253/circj.CJ-20-0567. Epub 2020 Oct 15.
Heart rate (HR) is an important factor in atrial fibrillation (AF); however, it remains unclear whether the impact of HR differs between paroxysmal AF and sustained (persistent and permanent) AF.
The association of resting HR during AF with adverse events (composite of all-cause death, hospitalization for heart failure, stroke/systemic embolisms, myocardial infarction, and arrhythmic events) in 1,064 paroxysmal and 1,610 sustained AF patients from the Fushimi AF Registry were investigated. These patients were divided into 4 groups based on their resting HR; ≥110 beats/min (bpm), 80-109 bpm, 60-79 bpm, and <60 bpm. The number of patients in each group was 486, 400, 172, and 22 for paroxysmal AF, and 205, 734, 645, and 71 for sustained AF, respectively. Among patients with sustained AF, a HR ≥110 bpm was associated with a higher incidence of adverse events at 1 year and during the entire follow up (median of 1,833 days) (hazard ratio [95% confidence interval] compared with a HR of 60-79 bpm: 1.90 [1.31-2.72] at 1 year, 1.38 [1.10-1.72] during the entire follow up). Patients with a HR <60 bpm showed higher incidence of adverse events at 1 year; however, the incidence of adverse events did not differ among all HR groups of paroxysmal AF.
Baseline HR was associated with adverse events in sustained AF, but not in paroxysmal AF.
心率（HR）是心房颤动（AF）的一个重要因素；然而，阵发性 AF 和持续性（持续性和永久性）AF 之间 HR 的影响是否不同仍不清楚。
研究了来自 Fushimi AF 登记处的 1064 例阵发性 AF 和 1610 例持续性 AF 患者的 AF 期间静息 HR 与不良事件（全因死亡、心力衰竭住院、卒中和全身性栓塞、心肌梗死和心律失常事件的复合事件）的相关性。根据静息 HR 将这些患者分为 4 组：≥110 次/分（bpm）、80-109 bpm、60-79 bpm 和<60 bpm。每组患者的数量分别为阵发性 AF 组 486、400、172 和 22 例，持续性 AF 组 205、734、645 和 71 例。在持续性 AF 患者中，HR≥110 bpm 与 1 年和整个随访期间（中位数为 1833 天）不良事件的发生率较高相关（与 60-79 bpm 相比的 HR：1 年时为 1.90 [1.31-2.72]，整个随访期间为 1.38 [1.10-1.72]）。HR<60 bpm 的患者在 1 年内发生不良事件的风险更高；然而，阵发性 AF 中所有 HR 组的不良事件发生率没有差异。
基线 HR 与持续性 AF 中的不良事件相关，但与阵发性 AF 无关。
