Resting heart rate assessed within clinical practice demonstrates no prognostic relevance for defibrillator recipients in the German DEVICE registry.

Autor: Alken FA; Division of Cardiology, Angiology and Intensive Care, cardiac Neuro- and Electrophysiology Research Consortium (cNEP), EVK Düsseldorf, Kirchfeldstr. 40, 40217, Düsseldorf, Germany., Senges J; Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany., Schneider S; Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany., Hochadel M; Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany., Brachmann J; Medical School REGIOMED, University of Split School of Medicine, Coburg, Split, Croatia., Kleemann T; Department of Cardiology/Pulmology/Angiology/Intensive Care, Klinikum Ludwigshafen, Ludwigshafen, Germany., Eckardt L; Department of Cardiology II-Electrophysiology, University Hospital Münster, Münster, Germany., Steinbeck G; Zentrum für Kardiologie und Angiologie, Starnberg, Germany., Leschke M; Medizinisches Versorgungszentrum Innere Medizin/Kardiologie, Esslingen, Germany., Stellbrink C; Department of Cardiology and Intensive Care Medicine, University Hospital OWL of Bielefeld University, Campus Klinikum Bielefeld, Bielefeld, Germany., Zrenner B; Department of Cardiology/Pulmology/Angiology/Intensive Care, Klinikum Landshut-Achdorf, Landshut, Germany., Becker R; Department of Cardiology/Pulmology/Nephrology/Angiology/Intensive Care, Klinikum Wolfsburg, Wolfsburg, Germany., Kahle AK; Division of Cardiology, Angiology and Intensive Care, cardiac Neuro- and Electrophysiology Research Consortium (cNEP), EVK Düsseldorf, Kirchfeldstr. 40, 40217, Düsseldorf, Germany.; Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany., Meyer C; Division of Cardiology, Angiology and Intensive Care, cardiac Neuro- and Electrophysiology Research Consortium (cNEP), EVK Düsseldorf, Kirchfeldstr. 40, 40217, Düsseldorf, Germany. christian.meyer@evk-duesseldorf.de.; Institute for Neural and Sensory Physiology, cardiac Neuro- and Electrophysiology Research Consortium (cNEP), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. christian.meyer@evk-duesseldorf.de.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Nov 25; Vol. 14 (1), pp. 29189. Date of Electronic Publication: 2024 Nov 25.
DOI: 10.1038/s41598-024-78851-z
Abstrakt: Resting heart rate (RHR) has prognostic implications in heart failure with reduced ejection fraction, where ≤ 70 bpm is targeted. Whether a RHR > 70 bpm assessed within clinical practice goes along with elevated cardiovascular risk in implantable cardioverter-defibrillator (ICD) / cardiac resynchronization therapy-defibrillator (CRT-D) recipients remains incompletely understood. A total of 1589 patients (ICD n = 1172 / CRT-D n = 417, median age 65 years, 22.6% female) undergoing ICD/CRT-D implantation or revision in the prospective German DEVICE multicenter registry were analyzed. RHR was assessed via a 12-channel electrocardiogram at enrollment. 1-year outcomes (all-cause mortality, major cardio- and cerebrovascular events (MACCE), all-cause hospital admission) were compared between patients with a RHR ≤ 70 bpm and > 70 bpm. 733 patients (46.1%) showed a RHR > 70 bpm. Median RHR was 63 (interquartile range 59; 68) bpm (≤ 70 bpm group) and 80 (75; 89) bpm (> 70 bpm group). Heart failure with reduced ejection fraction was present in 76.3%, a prior myocardial infarction in 32.4% and non-ischemic heart disease in 44.9%. One-year all-cause mortality was similar between RHR groups (≤ 70 bpm 5.4% vs. > 70 bpm 5.4%, p = 0.96), and subgroup analysis regarding patient characteristics and comorbidities revealed only a significantly higher rate of patients with dual chamber ICD in the > 70 bpm group (0.8% vs. 9.2%, p = 0.003). MACCE (5.9% vs. 6.1%, p = 0.87) and defibrillator shock rates (9.9% vs. 9.8%, p = 1.0) were similar. Higher all-cause hospital admission rates were observed in patients with > 70 bpm RHR (23.1% vs. 29.0%, p = 0.027) driven by non-cardiovascular events (6.0% vs. 11.7%, p = 0.001). In conclusion, in ICD and CRT-D recipients a RHR at admission > 70 bpm may indicate patients at increased risk of all-cause hospital admission but not of other adverse cardiovascular events or death at 1-year follow-up.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: