Elevated Resting Heart Rate in Hospitalized Patients With Atrial Fibrillation Is Associated With Increased Cardiovascular Risk.

BACKGROUND

Effective rate control is important in the management of atrial fibrillation (AF). However, the relationship between resting heart rate (RHR) and adverse outcomes in hospitalized patients remains uncertain.

OBJECTIVE

This study was to evaluate the association between RHR and in-hospital outcomes.

METHODS

Data from the Improving Care for Cardiovascular Disease in China-AF project from 2014 to 2019 were retrospectively analyzed. The primary outcome was the composite of in-hospital all-cause mortality and in-hospital acute heart failure (AHF). Secondary outcomes included stroke/transient ischemic attack (TIA) and bleeding during hospitalization. Logistic regression analyses were used to assess the association between RHR and outcomes.

RESULTS

Our study included 12,775 patients hospitalized for AF in 236 hospitals. Logistic regression analyses using different models showed a significant association between RHR exceeding 80 bpm and an increased risk of the primary outcome (adjusted OR: 1.79 [95% CI: 1.44-2.22]). A positive association between RHR and the primary outcome was identified with RHR ≥ 80 bpm. Marginal effect analyses showed that patients with advanced AF types were at higher risk across the range of RHR. Conversely, catheter ablation, but not antiarrhythmic drug use, was associated with a decreased risk.

CONCLUSION

A significant association was identified between RHR and adverse outcomes in patients hospitalized for AF, where RHR exceeding 80 bpm was associated with an increased risk. Trial Registration: ClinicalTrials.gov identifier: NCT02309398.