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Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study

D Moran1, A Buckley2, K Daly3

  • 1Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.

International Journal of Cardiology
|September 6, 2014
PubMed

Insights

A third of chronic heart failure patients do not meet guideline-recommended heart rates. Poor rate control is linked to respiratory issues, diabetes, and underutilization of key medications like beta-blockers and ivabradine.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • European Society of Cardiology guidelines recommend heart rates less than 70 bpm for patients with chronic stable heart failure.
  • Achieving target heart rates is crucial for managing heart failure and improving patient outcomes.

Purpose of the Study:

  • To assess adherence to heart rate guidelines in chronic stable heart failure patients.
  • To investigate the proportion of patients receiving target doses of rate-controlling medications.

Main Methods:

  • A multicenter study involving 549 patients across 12 heart failure centers in Ireland.
  • Included patients in sinus rhythm with stabilized heart failure treatment and no recent cardiac events.
  • Recorded resting heart rates, demographics, comorbidities, and heart failure therapies.

Main Results:

  • 32.1% of patients had heart rates ≥ 70 bpm, with 21.3% exceeding 75 bpm.
  • Failure to achieve target heart rates was associated with diabetes (42%), COPD (56%), and NYHA Class 3 (46%).
  • Only 25% of patients on beta-blockers were at the target dose; 69% not on beta-blockers did not achieve target heart rates.

Conclusions:

  • A significant proportion of stabilized chronic heart failure patients do not meet recommended heart rate targets.
  • Factors like respiratory problems, diabetes, and severe dyspnea correlate with poorer heart rate control.
  • Guideline awareness, optimal beta-blocker titration, and appropriate use of ivabradine are essential for effective heart rate management.
Abstract

Keywords:
Beta blockersGuidelinesHeart failureHeart rateIvabradine

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