Abstract:
BACKGROUND:There have been conflicting results about the role of strict rate control on cardiovascular outcomes in patients with chronic atrial fibrillation (AF). To date, large clinical studies have not shown a net clinical benefit derived from the current trend to specify the target ventricular rate according to the patient's own clinical and laboratory characteristics. Although the existing literature shows no superiority of strict rate control in clinical end points, it is difficult to assess the pure rate effect without commonly coexisting medication side effects which can also influence clinical end points. AIM:To determine the effects of strict rate control in patients with chronic AF, regarding objective parameters such as echocardiographic data and B-type natriuretic peptide (BNP) values. METHODS:38 patients with chronic AF for whom strict rate control had been planned were enrolled in the study. Patients' echocardiographic parameters, BNP values and 24 h Holter electrocardiography findings showing the average heart rate (HR), were studied at baseline and then monthly, until the end of the 3rd month. Patients' negative dromotropic therapy was adjusted to achieve a target resting HR of below 80 bpm. Laboratory and echocardiographic parameters at baseline and at the end of the study were compared in the whole study group. The whole study group was subclassified according to the average resting HRs achieved, (group 1 with strict rate control < 80 bpm; n = 25, and group 2 without strict rate control; n = 13). RESULTS:In group 1, the average HR declined from 101 ± 16.3 bpm to 77 ± 5.2 bpm. In group 2, the average HR was 96.6 ± 6.8 bpm at baseline and there was no significant change at the end of the study (94.2 ± 5.9 bpm). In group 1, there were significant decreases in BNP, left ventricular volumes, left atrial and right atrial areas at the end of the study. In group 2, BNP values were significantly higher at the end of the study despite similar ventricular and atrial dimensions according to the baseline. Diastolic functions were assessed roughly by septal E/e', but no significant change was observed in either group. CONCLUSIONS:Strict rate control in patients with chronic AF yielded a significant decrease in BNP values as well as a reduction in volumes of cardiac chambers.
journal_name
Kardiol Poljournal_title
Kardiologia polskaauthors
Ozkurt Y,Ozpelit E,Aslan O,Goldeli Odoi
10.5603/KP.a2014.0092subject
Has Abstractpub_date
2014-01-01 00:00:00pages
934-40issue
10eissn
0022-9032issn
1897-4279pii
VM/OJS/KP/8278journal_volume
72pub_type
杂志文章abstract::The paper presents a case of a 20-year-old student with a history of cardiac arrest due to ventricular fibrillation. The episode of cardiac arrest occurred when the patient did not complain of any health problems, and there was no visible structural heart disease. Consequently, permanent anoxaemic brain damage was obs...
journal_title:Kardiologia polska
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