How Heart Rate Should Be Controlled in Patients with Atherosclerosis and Heart Failure

Rose Mary Ferreira Lisboa da Silva, Anaisa Silva Roever Borges, Nilson Penha Silva, Elmiro Santos Resende, Gary Tse, Tong Liu, Leonardo Roever, Giuseppe Biondi-Zoccai

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Resting heart rate is an independent risk factor for all-cause and cardiovascular mortality in patients with heart failure. The main objectives are to discuss the prognosis of heart rate, its association with coronary atherosclerosis, and the modalities of control of the heart rate in sinus rhythm and in the rhythm of atrial fibrillation in patients with chronic heart failure. Recent Findings: As a therapeutic option for control heart rate, medications such as beta-blockers, digoxin, and finally ivabradine have been studied. Non-dihydropyridine calcium channel blockers are contraindicated in patients with heart failure and reduced ejection fraction. The influence of the magnitude of heart rate reduction and beta-blocker dose on morbidity and mortality will be discussed. Regarding the patients with heart failure and atrial fibrillation, there are different findings in heart rate control with the use of a beta-blocker. Patients eligible for ivabradine have clinical benefits and increased ejection fraction. Vagal nerve stimulation has low efficacy for the control of heart rate. Complementary therapies such as tai chi and yoga showed no effect on heart rate. Summary: In this review, we discuss the main therapeutic options for the control of heart rate in patients with atherosclerosis and heart failure. More research is needed to examine the effects of therapeutic options for heart rate control in different population types, as well as their effects on clinical outcomes and impact on morbidity and mortality.

Original languageEnglish
Article number54
JournalCurrent Atherosclerosis Reports
Volume20
Issue number11
DOIs
Publication statusPublished - Nov 1 2018

Keywords

  • Beta-blocker
  • Heart rate
  • Ivabradine
  • Mortality
  • Systolic heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    da Silva, R. M. F. L., Borges, A. S. R., Silva, N. P., Resende, E. S., Tse, G., Liu, T., Roever, L., & Biondi-Zoccai, G. (2018). How Heart Rate Should Be Controlled in Patients with Atherosclerosis and Heart Failure. Current Atherosclerosis Reports, 20(11), [54]. https://doi.org/10.1007/s11883-018-0757-3