ArticleClinical cardiology2025
Association Between Changes in Heart Rate and Adverse Events in Patients With Non-Valvular Atrial Fibrillation: A Post Hoc Analysis of the J-RHYTHM Registry.
Article in Clinical cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Authors' Reply to "Questioning the Rhythm: A Closer Look at Heart Rate Trends".Clinical cardiology · 2025Article
- Questioning the Rhythm: A Closer Look at Heart Rate Trends in Atrial Fibrillation.Clinical cardiology · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundWe previously reported that the heart rate (HR) at the time closest to an event or at the last visit during the follow-up period (HR-end) was more closely associated with adverse events (AEs) than baseline HR in patients with non-valvular atrial fibrillation (NVAF). However, it remains uncertain whether changes in HR during the follow-up period or absolute HR values would be more closely associated with AEs. Thus, we performed post hoc analyses using data from the J-RHYTHM Registry.
methodsOf 7406 outpatients with NVAF from 158 institutions, 6886 (age, 69.8 ± 9.9 years; men, 70.8%), who had both baseline HR and HR-end data, were included. Patients were divided into five groups based on the changing patterns of HR quartiles from baseline (< 63, 63-70, 71-79, and ≥ 80 beats per minute) to the end of follow-up (no-change, down-to-the-lowest-quartile, down-to-the-2nd or -3rd-quartile, up-to-the-2nd or -3rd-quartile, and up-to-the-highest-quartile).
resultsHazard ratios for AEs were significantly higher only in the up-to-highest-quartile group (2.89 [95% confidence interval, 1.71-4.90] for thromboembolism, 2.46 [1.53-3.95] for major hemorrhage, and 2.36 [1.51-3.70] for all-cause death) compared with the no-change group, after adjusting for confounding factors. Furthermore, in the no-change group, hazard ratios for AEs were significantly higher in the highest-to-highest-quartile subgroup (5.55 [1.49-20.77] for major hemorrhage and 3.60 [1.03-12.53] for all-cause death) compared with the 2nd-to-2nd-quartile subgroup.
conclusionsBoth excessive increases in HR and consistently high HR were independently associated with AEs in patients with NVAF. By contrast, modest decrease in HR during follow-up was associated with lower mortality. Accordingly, it is important to pay attention to changes in HR during follow-up for the management of patients with AF. CLINICAL
trial registrationThe J-RHYTHM Registry is registered in the University Hospital Medicine Information Network (UMIN) Clinical Trials Registry (unique identifier: UMIN000001569) http://www.umin.ac.jp/ctr/.
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