Heart rate and death and hospitalization for heart failure in patients with persistent or permanent atrial fibrillation: Insights from the ARISTOTLE trial.

Rate control is fundamental in the treatment of patients with atrial fibrillation (AF). The independent association of heart rate with outcomes and range of heart rate associated with best outcomes remains uncertain. We assessed the relationship between heart rate and clinical outcomes in patients with persistent or permanent AF enrolled in the randomized, double-blind ARISTOTLE trial. In patients with persistent or permanent AF, a faster heart rate is associated with a modest, but statistically significant increase in death and heart failure hospitalizations. TRIAL REGISTRATION: ClinicalTrials.gov (NCT00412984).

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Copyright © 2023. Published by Elsevier Inc.

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Disclosures Vinereanu: Research support from Pfizer/Bristol Myers Squibb.Wojdyla: None.Alexander: Institutional research grants from Artivion, Bayer Healthcare Pharmaceuticals, Bristol Myers Squibb, CSL Behring, National Institutes of Health, US Food and Drug Administration; data safety monitoring board for AbbVie, Inc.; consulting fees/honoraria for Antev, Bayer Healthcare Pharmaceuticals, Humacyte, Pfizer, Portola, VeraloxLopes: Institutional research grants: Bristol Myers Squibb, GlaxoSmithKline, Medtronic, Pfizer, Sanofi-Aventis; onsulting fees/honoraria from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, GlaxoSmithKline, Medtronic, Merck & Co., Inc., Pfizer, Portola, Sanofi-Aventis.Al-Khatib: Institutional research grants from Boston Scientific and Medtronic.Gersh: Data safety monitoring board for Bain Institute, Cardiovascular Research Foundation, Duke Clinical Research Institute, Icahn School of Medicine at Mount Sinai, Kowa Research Institute, Inc., Medtronic, Thrombosis Research Institute, V-Wave; advisory board for MyoKardia, Inc.Bahit: Consultant/advisory board member/speaker for Merck, Pfizer, Vifor Pharma.Hohnloser: Consulting fees/honoraria from Bristol Myers Squibb, Boehringer Ingelheim, Medtronic, Pfizer, Sanofi-Aventis, Zoll.Flaker: Nothing to report. Rosenquist: Nothing to report.Hijazi: Institutional research grant from Bristol Myers Squibb/Pfizer. Wallentin: Consulting fees/honoraria from Abbott; institutional research grants from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb/Pfizer, GlaxoSmithKline, Merck/Schering-Plough, Roche Diagnostics.Granger: Institutional research grants from Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, US Food and Drug Administration, GlaxoSmithKline, Janssen Pharmaceuticals, Medtronic Foundation, National Institutes of Health, Novartis Corporation, Pfizer; consulting fees/honoraria from Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardionomic, CeleCor, Correvio, Espero, HengRui, Janssen, Medscape, Medtronic, Inc., Merck & Co., Inc., Novo Nordisk, Pfizer, Phillips, Roche, National Institutes of Health; stock in Tenac.io.