TY - JOUR
T1 - Poor Heart Rate Recovery Is Associated With the Development of New-Onset Atrial Fibrillation in Middle-Aged Adults
AU - Sabbag, Avi
AU - Berkovitch, Anat
AU - Sidi, Yechezkel
AU - Kivity, Shaye
AU - Ben Zekry, Sagit
AU - Beinart, Roy
AU - Segev, Shlomo
AU - Glikson, Michael
AU - Goldenberg, Ilan
AU - Maor, Elad
N1 - Publisher Copyright:
© 2016 Mayo Foundation for Medical Education and Research
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Objective To investigate the association between heart rate recovery (HRR) and new-onset atrial fibrillation (AF) in middle-aged adults. Patients and Methods Heart rate recovery was calculated using the exercise stress test in 15,729 apparently healthy self-referred men and women who attended periodic health screening examinations between January 2000, and December 2015. All participants completed the maximal exercise stress test according to the Bruce protocol and were followed clinically on a yearly basis for a median of 6.4±4 years. The primary end point was new-onset AF. Participants were grouped according to HRR at 5 minutes, dichotomized at the median value (<73 beats/min). Results Participants with low HRR were older, were more commonly men, had a higher rate of comorbidities, and were less fit. Kaplan-Meier survival analysis revealed that the cumulative probability of AF at 6 years was higher in participants with low HRR (2.1%) than in those with high HRR (0.6%) (log-rank, P<.001). Older age, male sex, obesity resting heart rate, and ischemic heart disease were all associated with increased AF risk in a univariate Cox regression model (P<.05 for all). Multivariate Cox regression analysis revealed that low HRR was independently associated with increased AF risk (hazard ratio, 1.92; 95% CI, 1.3-2.8; P<.001) after adjustment for multiple confounders. Conclusion Lower HRR is independently associated with the development of new-onset AF during long-term follow-up in middle-aged adults.
AB - Objective To investigate the association between heart rate recovery (HRR) and new-onset atrial fibrillation (AF) in middle-aged adults. Patients and Methods Heart rate recovery was calculated using the exercise stress test in 15,729 apparently healthy self-referred men and women who attended periodic health screening examinations between January 2000, and December 2015. All participants completed the maximal exercise stress test according to the Bruce protocol and were followed clinically on a yearly basis for a median of 6.4±4 years. The primary end point was new-onset AF. Participants were grouped according to HRR at 5 minutes, dichotomized at the median value (<73 beats/min). Results Participants with low HRR were older, were more commonly men, had a higher rate of comorbidities, and were less fit. Kaplan-Meier survival analysis revealed that the cumulative probability of AF at 6 years was higher in participants with low HRR (2.1%) than in those with high HRR (0.6%) (log-rank, P<.001). Older age, male sex, obesity resting heart rate, and ischemic heart disease were all associated with increased AF risk in a univariate Cox regression model (P<.05 for all). Multivariate Cox regression analysis revealed that low HRR was independently associated with increased AF risk (hazard ratio, 1.92; 95% CI, 1.3-2.8; P<.001) after adjustment for multiple confounders. Conclusion Lower HRR is independently associated with the development of new-onset AF during long-term follow-up in middle-aged adults.
UR - http://www.scopus.com/inward/record.url?scp=85002526421&partnerID=8YFLogxK
U2 - 10.1016/j.mayocp.2016.08.012
DO - 10.1016/j.mayocp.2016.08.012
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:85002526421
SN - 0025-6196
VL - 91
SP - 1769
EP - 1777
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 12
ER -
