Influence of heart rate on quality of life in patients with chronic atrial fibrillation.

Background: Current criteria for rate control in atrial fibrillation (AF) treatment are empirical and based on a small amount of scientific data.

Hypothesis: This study was designed to analyze the influence of heart rate (HR, measured by the 6-minute walk test [6MWT] and 24-hour Holter monitoring) on quality of life (QoL).

Methods: A total of 89 male patients with chronic atrial fibrillation (AF) and resting HR < 90 bpm were included. QoL (assessed by the Short Form-36 Health Survey [SF-36] questionnaire) was compared among 3 groups of patients classified by HR testing results: group 1 had HR < or = 110 bpm on 6MWT and < or = 80 bpm on Holter monitor; group 2 had HR in the target area by 1 but not both tests; and group 3 had HR > 110 bpm on 6MWT and > 80 bpm on Holter monitor.

Results: There were significant differences among the 3 groups in physical and mental component summary scores (285.9 +/- 73.9; 276.6 +/- 80.8; 230.3 +/- 91.0, P = .035; and 319.8 +/- 70.2; 294.7 +/- 76.0; 255.0 +/- 107.1, P = .026, respectively).When the methods were analyzed separately, there was a significant difference on QoL in physical and mental summary scores in patients with maximal HR < or = 110 bpm on 6MWT in comparison with HR > 110 bpm (P = .04 and P = .01, respectively) and in the physical summary score in patients with average HR < or = 80 bpm on Holter monitor in comparison with HR > 80 bpm (P = .02).

Conclusions: Holter monitoring and 6MWT should be performed as complementary methods to better predict QoL.