Kato, Yuko;
Suzuki, Shinya; Uejima, Tokuhisa; Semba, Hiroaki; Nagayama, Osamu;
Hayama, Etsuko; Yamashita, Takeshi.

European Journal of Preventive
Cardiology, September 2016, Vol. 23 Issue: Number 13 p1429-1436, 8p;

Abstract: Background  Resting heart rate is a surrogate marker
associated with achieved exercise capacity, which has been observed in
patients with sinus rhythm. The aim of this study was to examine and
compare the relationships between resting heart rate and peak oxygen
consumption in atrial fibrillation and sinus rhythm.Methods and results
A total of 2160 consecutive patients undergoing cardiopulmonary
exercise testing in our single-hospital cohort were divided into two
groups according to rhythm status: an atrial fibrillation group
(N= 320) and a sinus rhythm group (N= 1840). In the total cohort and
sinus rhythm group, resting heart rate was negatively correlated with
percentage of predicted peak oxygen consumption (Ptrend< 0.0001); in
atrial fibrillation patients, this correlation was apparently positive
(Ptrend= 0.032). Multivariate analysis of the total cohort showed a
significant interaction between resting heart rate and rhythm status
for peak oxygen consumption after adjustments for age, sex, ejection
fraction, structural heart diseases and heart rate-lowering drugs. In
the sinus rhythm group, resting heart rate was an independent, negative
contributing factor for peak oxygen consumption, even after the
adjustments for patient background. However, in the atrial fibrillation
group, resting heart rate was a weak positive or non-independent
contributing factor for peak oxygen consumption after the same
adjustments.Conclusions  The impact of resting heart rate on exercise
capacity differed completely between atrial fibrillation and sinus
rhythm, suggesting that heart rate control may need to be managed
differently for atrial fibrillation and sinus rhythm, in light of
exercise capacity that is related to quality of life and prognosis.