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Cardiac Arrhythmias 2003 pp 99–105Cite as

Rate Control of Atrial Fibrillation: By How Much Should the Ventricular Rate be Lowered?

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Abstract

Heart rate (HR) should be neither too high, since it can be responsible for tachycardia-induced cardiomyopathy [1, 2], nor too low, since it can facilitate the appearance of heart failure, at least in old people with heart disease [3,4], Moreover, mounting evidence shows that an elevated resting sinus rate is a predictor of cardiovascular morbidity and mortality. In fact, in multivariate analysis, a high sinus rate emerged as an independent predictor of mortality in the general population [5], in elderly subjects [6], and in selected groups of patients with hypertension [7] or myocardial infarction [8]. At present the prognostic value of resting HR in patients with chronic atrial fibrillation (AF) is unknown; however, it should be expected to be the same.

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References

  1. Keane JF, Plauth WH, Nadas AS (1974) Chronic ectopic tachycardia of infancy and childhood. Am Heart J 84:748–757

    Article  Google Scholar 

  2. Peters KG, Kienzle MG (1988) Severe cardiomyopathy due to chronic rapidly conducted atrial fibrillation: complete recovery after restoration of sinus rhythm. Am J Med 85:242–244

    Article  PubMed  CAS  Google Scholar 

  3. Alboni P, Menozzi C, Brignole M et al (1997) Effects of permanent pacemaker and oral theophylline in sick sinus syndrome. The THEOPACE study: a randomized controlled trial. Circulation 96:260–266

    Article  PubMed  CAS  Google Scholar 

  4. Alboni P, Brignole M, Menozzi C, ScarfÒ S (1999) Is sinus bradycardia a factor facilitating overt heart failure? Eur Heart J 20:252–255

    Article  PubMed  CAS  Google Scholar 

  5. Kannel WB, Kannel C, Paffenbarger RS, Cupples LA (1987) Heart rate and cardiovascular mortality: the Framingham study. Am Heart J 113:1489–1494

    Article  PubMed  CAS  Google Scholar 

  6. Aronow WS, Ahn C, Mercando AD et al (1996) Association of average heart rate on 24-hour ambulatory electrocardiograms with incidence of new coronary events at 48-month follow-up in 1311 patients (mean age 81 years) with heart disease and sinus rhythm. Am J Cardiol 78:1175–1176

    PubMed  CAS  Google Scholar 

  7. Gillman MW, Kannel WB, Belanger A, D’Agostino RB (1993) Influence of heart rate on mortality among persons with hypertension: the Framingham study. Am Hear J 125:1148–1154

    Article  CAS  Google Scholar 

  8. Zuanetti G, Hernandez-Bernal F, Rossi A et al (1999) Relevance of heart rate as a prognostic factor in myocardial infarction: the GISSI experience. Eur Heart J 1:52H–57H

    Google Scholar 

  9. Geddes LA, Wessale JL (1991) Cardiac output, stroke volume and pacing rate: a review of the literature and a proposed technique for selection of the optimum pacing rate for an exercise responsive pacemaker. J Cardiovasc Electrophysiol 2:408–415

    Article  Google Scholar 

  10. Payne G, Spinelli J, Garrat CJ, Skehan JD (1997) The optimal pacing rate: an umpre-dictable parameter. Pacing Clin Electrophysiol 20:866–873

    Article  PubMed  CAS  Google Scholar 

  11. Atwood JE, Myers J, Sullivan M et al (1989) The effect of cardioversion on maximal exercise capacity in patients with chronic atrial fibrillation. Am Heart J 118:913–918

    Article  PubMed  CAS  Google Scholar 

  12. Ostermaier RH, Lampert S, Dalla Vecchia L, Ravid S (1997) The effect of atrial fibrillation and the ventricular rate control on exercise capacity. Clin Cardiol 20:23–27

    Article  PubMed  CAS  Google Scholar 

  13. Ueshima K, Myers J, Ribisl PM et al (1993) Hemodynamic determinants of exercise capacity in chronic atrial fibrillation. Am Heart J 125:1301–1305

    Article  PubMed  CAS  Google Scholar 

  14. Atwood JE, Myers J, Sullivan M et al (1988) Maximal exercise testing and gas exchange in patients with chronic atrial fibrillation. J Am Coll Cardiol 11:508–513

    Article  PubMed  CAS  Google Scholar 

  15. Corbelli R, Masterson R, Wilkoff BL (1990) Chronotropic response to exercise in patients with atrial fibrillation. Pacing Clin Electrophysiol 13:179–187

    Article  PubMed  CAS  Google Scholar 

  16. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation (2001) Eur Heart J 22:1852–1923

    Article  Google Scholar 

  17. Resnekov L, McDonald L (1971) Electroconversion of lone atrial fibrillation and flutter including hemodynamic studies at rest and on exercise. Br Heart J 33:339–350

    Article  PubMed  Google Scholar 

  18. Atwood JE, Myers J, Sandhu S et al (1989) Optimal sampling interval to estimate heart rate at rest and during exercise in atrial fibrillation. Am J Cardiol 63:45–48

    Article  PubMed  CAS  Google Scholar 

  19. Rawles JM (1990) What is meant by a “controlled” ventricular rate in atrial fibrillation? Br Heart J 63:157–161

    Article  PubMed  CAS  Google Scholar 

  20. Zhang Y, Mowrey KA, Zhuang S et al (2002) Optimal ventricular rate slowing during atrial fibrillation by feedback AV nodal-selective vagal stimulation. Am J Physiol Heart Circ Physiol 282:H1102–H1110

    PubMed  CAS  Google Scholar 

  21. Sunagawa K, Maughan WL, Sagawa K (1985) Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. Circ Res 56:586–595

    Article  PubMed  CAS  Google Scholar 

  22. Nobuoka S, Hatano S, Nagashima J et al (2002) Determination of the target ventricular rate in patients with atrial fibrillation by evaluation of ventriculoarterial coupling. Tex Heart Inst 29:100–104

    Google Scholar 

  23. Lang R, Klein HO, Weiss E et al (1983) Superiority of oral verapamil therapy to digoxin in treatment of chronic atrial fibrillation. Chest 83:491–499

    Article  PubMed  CAS  Google Scholar 

  24. Beasley R, Smith DA, McHaggie DJ (1985) Exercise heart rate at different serum digoxin concentration in patients with atrial fibrillation. Br Med J 290:9–11

    Article  CAS  Google Scholar 

  25. Zarowitz BJ, Gheorghiede M (1992) Optimal heart rate control for patients with chronic atrial fibrillation: are pharmacological choices truly changing? Am Heart J 123:1401–1403

    Article  PubMed  CAS  Google Scholar 

  26. Yahalom J, Klein H, Kaplinsky E (1977) Beta-adrenergic blockade as adjunctive oral therapy in patients with chronic atrial fibrillation. Chest 71:582–592

    Article  Google Scholar 

  27. Di Bianco R, Morganroth J, Freitag JA et al (1984) Effects of nadolol on the spontaneous and exercise-provoked heart rate of patients with chronic atrial fibrillation receiving stable dosages of digoxin. Am Heart J 108:1121–1127

    Article  Google Scholar 

  28. Molajo AO, Coupe MO, Bennet DH (1984) Effect of Corwin (ICI 118587) on resting and exercise heart rate and exercise tolerance in digitalised patients with chronic atrial fibrillation. Br Heart J 52:392–395

    Article  PubMed  CAS  Google Scholar 

  29. Atwood JE, Sullivan M, Forbes S et al (1987) Effects of beta-adrenergic blockade on exercise performance in patients with chronic atrial fibrillation. J Am Coll Cardiol 10:314–320

    Article  PubMed  CAS  Google Scholar 

  30. Zoble RG, Brewington J, Olukotun AY et al (1987) Comparative effects of nadolol-digoxin combination therpay and digoxin monotherapy for chronic atrial fibrillation. Am J Cardiol 60: 39D-45D

    Google Scholar 

  31. Wong CK, Lau CP, Leung WH et al (1990) Usefulness of labetalol in chronic atrial fibrillation. Am J Cardiol 66:1212–1215

    Article  PubMed  CAS  Google Scholar 

  32. Atwood JE, Myers J, Quaglietti S et al (1999) Effect of betaxolol on the hemodynamic, gas exchange, and cardiac output to exercise in chronic atrial fibrillation. Chest 115:1175–1180

    Article  PubMed  CAS  Google Scholar 

  33. Lundstrom T, Ryden L (1990) Ventricular rate control and exercise performance in chronic atrial fibrillation: effects of diltiazem and verapamil. J Am Coll Cardiol 16:86–90

    Article  PubMed  CAS  Google Scholar 

  34. Channer KS, Papouchado M, James MA, Pitcher DW, Rees JR (1987) Towards improved control of atrial fibrillation. Eur Hear J 8:141–147

    CAS  Google Scholar 

  35. Steinberg JS, Katz RJ, Bren GB, Buff LA, Varghese PJ (1987) Efficacy of oral diltiazem to control ventricular response in chronic atrial fibrillation at rest and during exercise. J Am Coll Cardiol 9:405–411

    Article  PubMed  CAS  Google Scholar 

  36. Lewis RV, Irvine N, McDevitt DG (1988) Relationships between heart rate, exercise tolerance and cardiac output in atrial fibrillation: the effects of treatment with digoxin, verapamil and diltiazem. Eur Heart J 9:777–781

    Article  PubMed  CAS  Google Scholar 

  37. Lang R, Klein HO, Di Segni E et al (1983) Verapamil improves exercise capacity in chronic atrial fibrillation: double-blind crossover study. Am Heart J 105:820–825

    Article  PubMed  CAS  Google Scholar 

  38. Kjekshus J, Gullestad L (1999) Heart rate as therapeutic target in heart failure. Eur Heart J (Suppl 1):H64–H69

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Cardiology and Arrhythmologic Center, Cento (Fe), Italy

    P. Alboni, L. Gianfranchi, G. Fucà & F. Pacchioni

  2. Vitatron, Italy

    G. Corbucci

Authors
  1. P. Alboni
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  2. L. Gianfranchi
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  3. G. Fucà
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  4. F. Pacchioni
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  5. G. Corbucci
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Editor information

Editors and Affiliations

  1. Divisione di Cardiologia, Ospedale Umberto I, Via Circonvallazione 50, I-30174, Venezia, Mestre, Italy

    Antonio Raviele MD

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© 2004 Springer-Verlag Italia

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Alboni, P., Gianfranchi, L., Fucà, G., Pacchioni, F., Corbucci, G. (2004). Rate Control of Atrial Fibrillation: By How Much Should the Ventricular Rate be Lowered?. In: Raviele, A. (eds) Cardiac Arrhythmias 2003. Springer, Milano. https://doi.org/10.1007/978-88-470-2137-2_14

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  • DOI: https://doi.org/10.1007/978-88-470-2137-2_14

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2177-8

  • Online ISBN: 978-88-470-2137-2

  • eBook Packages: Springer Book Archive

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