Background:Heart rate (HR) is an important factor in atrial fibrillation (AF); however, it remains unclear whether the impact of HR differs between paroxysmal AF and sustained (persistent and permanent) AF.

Methods and Results:The association of resting HR during AF with adverse events (composite of all-cause death, hospitalization for heart failure, stroke/systemic embolisms, myocardial infarction, and arrhythmic events) in 1,064 paroxysmal and 1,610 sustained AF patients from the Fushimi AF Registry were investigated. These patients were divided into 4 groups based on their resting HR; ≥110 beats/min (bpm), 80–109 bpm, 60–79 bpm, and <60 bpm. The number of patients in each group was 486, 400, 172, and 22 for paroxysmal AF, and 205, 734, 645, and 71 for sustained AF, respectively. Among patients with sustained AF, a HR ≥110 bpm was associated with a higher incidence of adverse events at 1 year and during the entire follow up (median of 1,833 days) (hazard ratio [95% confidence interval] compared with a HR of 60–79 bpm: 1.90 [1.31–2.72] at 1 year, 1.38 [1.10–1.72] during the entire follow up). Patients with a HR <60 bpm showed higher incidence of adverse events at 1 year; however, the incidence of adverse events did not differ among all HR groups of paroxysmal AF.

Conclusions:Baseline HR was associated with adverse events in sustained AF, but not in paroxysmal AF.

背景：心率（HR）是房颤（AF）的重要因素；然而，目前尚不清楚 HR 对阵发性 AF 和持续性（持续性和永久性）AF 的影响是否不同。

方法和结果：研究了伏见 AF Registry 中 1,064 名阵发性和 1,610 名持续性 AF 患者的 AF 期间静息 HR 与不良事件（包括全因死亡、心力衰竭住院、中风/全身栓塞、心肌梗死和心律失常事件）的关联. 这些患者根据静息心率分为 4 组；≥110 次/分钟 (bpm)、80–109 bpm、60–79 bpm 和 <60 bpm。每组患者数分别为阵发性 AF 486、400、172、22 例，持续性 AF 205、734、645、71 例。在持续性 AF 患者中，HR ≥ 110 bpm 与 1 年和整个随访期间（中位数为 1,833 天）的不良事件发生率较高相关（风险比 [95% 置信区间] 与 HR 为 60 –79 bpm：1 年时 1.90 [1.31–2.72]，1.38 [1.10–1。72] 在整个随访期间）。HR <60 bpm 的患者在 1 年时显示出较高的不良事件发生率；然而，所有阵发性 AF 的 HR 组的不良事件发生率没有差异。

结论：基线 HR 与持续性 AF 的不良事件相关，但与阵发性 AF 无关。