Comparison of rate assessment between resting heart rate and 24-hour Holter monitoring in patients with chronic atrial fibrillation.

BACKGROUND

Target heart rate in rate control strategy has been proposed by the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. There is limited data on the correlation of measured heart rate at rest and during Holter monitoring.

OBJECTIVE

To evaluate the proportion of achieved target heart rate between resting heart rate measuring and 24-hour Holter monitoring in patients with chronic atrial fibrillation who receive rate control strategy.

MATERIAL AND METHOD: Patients with chronic atrial fibrillation who archived target resting heart rate under rate control strategy at Siriraj Hospital and who underwent 24-hour Holter monitoring were studied to evaluate the correlation between two methods of heart rate control.

RESULTS

47 patients were enrolled. Underlying cardiac conditions were as follows: hypertensive heart disease 44.7%, valvular heart disease 25%, coronary artery disease 17% and dilated cardiomyopathy 12.8%. There were 10 patients (21.3%) whose achieving target resting heart rate was not correlated with 24-hour Holter monitoring. Three patients (6.4%) underwent permanent pacemaker implantation due to sick sinus syndrome (SSS) or tachycardia-bradycardia syndrome.

CONCLUSION

In chronic atrial fibrillation patients that receive rate control strategy, evaluation of only resting heart rate might not be enough for long-term evaluation and treatment and 24-hour monitoring may be an additional helpful test in order to more precisely adjust medication for long-term treatment and detection of SSS.