Related Experiment Video

Updated: Mar 2, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

2.2K

Heart rate and outcome in heart failure with reduced ejection fraction: Differences between atrial fibrillation and

Bart A Mulder1, Kevin Damman1, Dirk J Van Veldhuisen1

  • 1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Clinical Cardiology
|May 18, 2017
PubMed

Insights

In heart failure with reduced ejection fraction (HFREF), elevated heart rate predicts worse outcomes in sinus rhythm but not in atrial fibrillation (AF). This finding is crucial for managing HFREF patients with different heart rhythms.

Area of Science:

  • Cardiology
  • Clinical Research
  • Heart Failure Management

Background:

  • Prognostic significance of heart rate is established in heart failure with reduced ejection fraction (HFREF) patients with sinus rhythm.
  • The impact of heart rate on prognosis in HFREF patients with atrial fibrillation (AF) remains unclear.

Purpose of the Study:

  • To investigate the influence of cardiac rhythm and baseline heart rate on outcomes in HFREF patients.
  • To evaluate the prognostic value of heart rate in HFREF patients with either sinus rhythm or AF.

Main Methods:

  • Stratification of 2539 HFREF patients based on baseline heart rhythm (AF or sinus rhythm) and heart rate quartiles.
  • Primary outcome assessed was all-cause mortality over a mean follow-up of 1.3 years.

Main Results:

  • A significant interaction was observed between heart rate, rhythm, and all-cause mortality (P=0.041).
  • In sinus rhythm, each 5 bpm increase in heart rate was associated with increased mortality (HR: 1.06, 95% CI: 1.01-1.11).
  • In AF, heart rate was not significantly associated with mortality (HR: 1.00, 95% CI: 0.94-1.07).

Conclusions:

  • Higher heart rate is not associated with increased mortality in HFREF patients with AF.
  • In contrast, elevated heart rate is linked to worse outcomes in HFREF patients with sinus rhythm.
Abstract

Keywords:
Atrial FibrillationBisoprololCardiovascular OutcomeHeart FailureHeart Rate

More Related Videos

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

692
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

34.2K

Related Concept Videos

ECG Interpretation of Arrhythmias I: Sinus Arrhythmias01:16

ECG Interpretation of Arrhythmias I: Sinus Arrhythmias

Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
941
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
675
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
486
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
711
Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
701
Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
578