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Keywords = the median hourly ambulatory heart rate range

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13 pages, 2748 KiB

Open AccessArticle

Is the Median Hourly Ambulatory Heart Rate Range Helpful in Stratifying Mortality Risk among Newly Diagnosed Atrial Fibrillation Patients?

by Hsing-Yu Chen, John Malik, Hau-Tieng Wu and Chun-Li Wang

J. Pers. Med. 2021, 11(11), 1202; https://doi.org/10.3390/jpm11111202 - 14 Nov 2021

Cited by 2 | Viewed by 2258

Abstract

Background: The application of heart rate variability is problematic in patients with atrial fibrillation (AF). This study aims to explore the associations between all-cause mortality and the median hourly ambulatory heart rate range (

{\tilde{A H R R}}_{24 h r}

) [...] Read more.

{\tilde{A H R R}}_{24 h r}

) compared with other parameters obtained from the Holter monitor in patients with newly diagnosed AF. Material and Methods: A total of 30 parameters obtained from 521 persistent AF patients’ Holter monitor were analyzed retrospectively from 1 January 2010 to 31 July 2014. Every patient was followed up to the occurrence of death or the end of 30 June 2017. Results:

{\tilde{A H R R}}_{24 h r}

was the most feasible Holter parameter. Lower

{\tilde{A H R R}}_{24 h r}

was associated with increased risk of all-cause mortality (adjusted hazard ratio [aHR] for every 10-bpm reduction: 2.70, 95% confidence interval [CI]: 1.75–4.17, p < 0.001). The C-statistic of

{\tilde{A H R R}}_{24 h r}

alone was 0.707 (95% CI: 0.658–0.756), and 0.697 (95% CI: 0.650–0.744) for the CHA2DS2-VASc score alone. By combining

{\tilde{A H R R}}_{24 h r}

with the CHA2DS2-VASc score, the C-statistic could improve to 0.764 (95% CI: 0.722–0.806). While using 20 bpm as the cut-off value, the aHR was 3.66 (95% CI: 2.05–6.52) for patients with

{\tilde{A H R R}}_{24 h r}

< 20 bpm in contrast to patients with

{\tilde{A H R R}}_{24 h r}

≥ 20 bpm. Conclusions:

{\tilde{A H R R}}_{24 h r}

could be helpful for risk stratification for AF in addition to the CHA2DS2-VASc score. Full article

(This article belongs to the Special Issue Cardiac Disease: Diagnosis, Treatment, and Outcomes)

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