Jeong Joo Hee, Baek Yong-Soo, Park Junbeom, Park Hyung Wook, Choi Eue-Keun, Park Jin-Kyu, Kang Ki-Woon, Kim Jun, Lee Young Soo, Kim Jin-Bae, Choi Jong-Il, Joung Boyoung, Shim Jaemin
Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon 22332, Republic of Korea.
J Clin Med. 2024 Sep 14;13(18):5469. doi: 10.3390/jcm13185469.
: Relatively little has been established about the association of rapid ventricular response (RVR) with further recurrence of atrial fibrillation (AF). This study investigated the impact of RVR on the recurrence of AF. : Data were obtained from a multicenter, prospective registry of non-valvular AF patients. RVR was defined as AF with a ventricular rate > 110 bpm. The primary endpoint was the recurrence of AF, defined as the first AF detected on 12-lead electrocardiography during follow-up. Secondary endpoints included manifestation of AF during follow-up and major adverse cardiovascular events (MACEs), a composite of thromboembolic events, major bleeding, myocardial infarction, and death. : Among 5533 patients, 493 (8.9%) presented RVR. Patients with RVR were younger, had smaller left atrial diameters, and more frequently had paroxysmal AF. During the mean follow-up duration of 28.6 months, the RVR group exhibited significantly lower recurrence of AF (hazard ratio: 0.58, 95% confidence interval: 0.53-0.65, < 0.001). There was no significant difference in the occurrence of MACEs between patients with RVR and those without RVR (0.96, 0.70-1.31, = 0.800). AF with RVR was identified as an independent negative predictor of AF recurrence (0.61, 0.53-0.71, < 0.001). : In patients with AF, those with RVR had a significantly lower recurrence of AF without an increase in MACEs. RVR is a favorable marker that may benefit from early rhythm control.
关于快速心室率反应（RVR）与房颤（AF）进一步复发之间的关联，目前已明确的内容相对较少。本研究调查了RVR对AF复发的影响。
数据来自一项多中心、前瞻性的非瓣膜性AF患者登记研究。RVR定义为心室率>110次/分钟的AF。主要终点是AF复发，定义为随访期间12导联心电图检测到的首次AF。次要终点包括随访期间AF的表现以及主要不良心血管事件（MACE），MACE是血栓栓塞事件、大出血、心肌梗死和死亡的综合指标。
在5533例患者中，493例（8.9%）出现RVR。RVR患者更年轻，左心房直径更小，阵发性AF更为常见。在平均28.6个月的随访期间，RVR组的AF复发率显著较低（风险比：0.58，95%置信区间：0.53 - 0.65，P<0.001）。RVR患者和无RVR患者之间MACE的发生率无显著差异（0.96，0.70 - 1.31，P = 0.800）。伴有RVR的AF被确定为AF复发的独立负性预测因子（0.61，0.53 - 0.71，P<0.001）。
在AF患者中，伴有RVR的患者AF复发率显著较低，且MACE无增加。RVR是一个有利的标志物，可能从早期节律控制中获益。
