Chen HY, Malik J, Wu HT, Wang CL. Is
the Median Hourly Ambulatory Heart Rate Range Helpful in Stratifying Mortality Risk among Newly Diagnosed Atrial Fibrillation Patients?
J Pers Med 2021;
11:jpm11111202. [PMID:
34834554 PMCID:
PMC8622712 DOI:
10.3390/jpm11111202]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 01/22/2023] Open
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 (AHRR˜24hr) 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:AHRR˜24hr was the most feasible Holter parameter. Lower AHRR˜24hr 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 AHRR˜24hr 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 AHRR˜24hr 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 AHRR˜24hr < 20 bpm in contrast to patients with AHRR˜24hr ≥ 20 bpm. Conclusions:AHRR˜24hr could be helpful for risk stratification for AF in addition to the CHA2DS2-VASc score.
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