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How Heart Rate Should Be Controlled in Patients with Atherosclerosis and Heart Failure

Rose Mary Ferreira Lisboa da Silva1, Anaisa Silva Roever Borges2, Nilson Penha Silva3

  • 1Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. roselisboa@uol.com.br.

Current Atherosclerosis Reports
|September 19, 2018
PubMed

Insights

Resting heart rate impacts mortality in heart failure patients. This review examines heart rate control strategies, including medications like beta-blockers and ivabradine, for patients with atherosclerosis and heart failure.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Resting heart rate is a significant predictor of mortality in heart failure patients.
  • Elevated heart rate is linked to coronary atherosclerosis and adverse cardiovascular outcomes.

Purpose of the Study:

  • To review the prognostic implications of heart rate in heart failure.
  • To discuss heart rate control strategies in sinus rhythm and atrial fibrillation.
  • To explore the association between heart rate and coronary atherosclerosis.

Main Methods:

  • Literature review of therapeutic options for heart rate control.
  • Analysis of medications including beta-blockers, digoxin, and ivabradine.
  • Evaluation of non-pharmacological interventions and their efficacy.

Main Results:

  • Beta-blockers, digoxin, and ivabradine are key medications for heart rate control.
  • Non-dihydropyridine calcium channel blockers are contraindicated in heart failure with reduced ejection fraction.
  • Ivabradine shows clinical benefits and improves ejection fraction in eligible patients.
  • Vagal nerve stimulation and complementary therapies like tai chi and yoga have limited efficacy.

Conclusions:

  • Effective heart rate management is crucial for improving outcomes in heart failure patients.
  • Further research is needed to optimize heart rate control strategies across diverse patient populations.
  • Tailoring heart rate control to specific arrhythmias and patient profiles is essential.
Abstract

Keywords:
Beta-blockerHeart rateIvabradineMortalitySystolic heart failure

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