Impaired Heart Rate Recovery Is Associated With New-Onset Atrial Fibrillation

January 2019

Heart Disease

Country of origin: USA

Autonomic dysfunction appears to play a significant role in the development of atrial fibrillation (AF), and impaired heart rate recovery (HRR) during exercise treadmill testing (ETT) is a known marker for autonomic dysfunction. However, whether impaired HRR is associated with incident AF is unknown. Recently published research studies the association of impaired HRR with the development of incident AF, after controlling for demographic and clinical confounders.

Researchers studied 8236 patients referred for ETT between 2001 and 2004, and without a prior history of AF. Patients were categorized by normal or impaired HRR on ETT. The primary outcome was the development of AF. Cox proportional hazards modelling was used to control for demographic and clinical characteristics. Secondary analyses exploring a continuous relationship between impaired HRR and AF, and exploring interactions between cardiac medication use, HRR, and AF were also conducted.

The results showed that after adjustment, patients with impaired HRR were more likely to develop AF than patients with normal HRR. In addition, there was a linear trend between impaired HRR and AF. No interactions between cardiac medications, HRR, and AF were noted.

The research concludes that patients with impaired HRR on ETT were more likely to develop new-onset AF, as compared to patients with normal HRR. These findings support the hypothesis that autonomic dysfunction mediates the development of AF, and suggest that interventions known to improve HRR, such as exercise training, may delay or prevent AF.

The BMC Cardiovascular Disorders article is available online.

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