{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:09:03Z","timestamp":1778742543036,"version":"3.51.4"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":58,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Libbs Farmac\u00eautica"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) with slow ventricular response is a clinically challenging condition, particularly in elderly patients with multiple comorbidities. Current therapeutic options for the chronic pharmacological management of bradycardia remain limited. The aim of this study was to evaluate the effects of cilostazol on heart rate (HR) and ventricular arrhythmia in patients with permanent AF and a slow ventricular response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This was a randomized, double-blind, placebo-controlled trial including 26 patients with permanent AF and a mean HR &amp;lt;65bpm on 24-hour Holter monitoring. Patients were randomized to receive cilostazol 100\u2005mg twice daily (n = 14) or placebo (n = 12) for 3 months. The primary endpoint was the increase in mean HR. After 30 days of treatment, the cilostazol group demonstrated a significant increase in minimum HR (from 34.17 to 39.14 bpm; P = 0.032) and mean HR (from 55.42 to 64.43 bpm; P = 0.013) compared to placebo. The total number of QRS complexes increased significantly (from 73879 to 85249 P = 0.029), and the number of cardiac pauses (&amp;gt;2.5\u2005s) was significantly reduced (mean from 56.25 to 2.57 and median from 5.5 to 0.0 P = 0.018). No significant differences were observed in the incidence of ventricular arrhythmias. Adverse effects were mild and included headache and gastrointestinal symptoms, with no statistical difference between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cilostazol significantly increased HR in patients with AF and slow ventricular response without increasing ventricular arrhythmias. These findings suggest that cilostazol may represent a pharmacological alternative for selected patients when pacemaker implantation is not immediately feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeag068","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T11:38:35Z","timestamp":1776944315000},"source":"Crossref","is-referenced-by-count":0,"title":["Cilostazol for heart rate increase in atrial fibrillation with slow ventricular response: an exploratory randomized controlled trial"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4860-4174","authenticated-orcid":false,"given":"Gabriela Hinkelmann","family":"Berbert","sequence":"first","affiliation":[{"name":"Electrophysiology Department, Instituto Dante Pazzanese de Cardiologia , Sao Paulo ,","place":["Brazil"]},{"name":"Arrhythmia Center, Einstein Hospital Israelita , Sao Paulo, SP ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5168-8496","authenticated-orcid":false,"given":"Rogerio Braga","family":"Andalaft","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Instituto Dante Pazzanese de Cardiologia , Sao Paulo ,","place":["Brazil"]},{"name":"Arrhythmia Center, Einstein Hospital Israelita , Sao Paulo, SP ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0676-2033","authenticated-orcid":false,"given":"Bruno Pereira","family":"Valdigem","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Instituto Dante Pazzanese de Cardiologia , Sao Paulo ,","place":["Brazil"]},{"name":"Arrhythmia Center, Einstein Hospital Israelita , Sao Paulo, SP ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana Vidal","family":"Armaganijan","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Instituto Dante Pazzanese de Cardiologia , Sao Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-7057","authenticated-orcid":false,"given":"Fabio Antonio","family":"Venancio","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Instituto Dante Pazzanese de Cardiologia , Sao Paulo ,","place":["Brazil"]},{"name":"Nursing Department, Centro Universit\u00e1rio de Adamantina , Sao Paulo, SP ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalmo Antonio Ribeiro","family":"Moreira","sequence":"additional","affiliation":[{"name":"Electrophysiology Department, Instituto Dante Pazzanese de Cardiologia , Sao Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"2026051402265956100_oeag068-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5935\/abc.20160055","article-title":"II diretrizes brasileiras de fibrila\u00e7\u00e3o atrial","volume":"106","author":"Magalh\u00e3es","year":"2016","journal-title":"Arq Bras Cardiol"},{"key":"2026051402265956100_oeag068-B2","article-title":"2018 ACC\/AHA\/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay","volume":"140","author":"Kusumoto","year":"2019","journal-title":"Circulation"},{"key":"2026051402265956100_oeag068-B3","doi-asserted-by":"crossref","DOI":"10.36660\/abc.20220892","article-title":"Diretriz brasileira de dispositivos card\u00edacos eletr\u00f4nicos implant\u00e1veis \u2013 2023","volume":"120","author":"Teixeira","year":"2023","journal-title":"Arq Bras Cardiol"},{"key":"2026051402265956100_oeag068-B4","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s10557-021-07187-x","article-title":"Cilostazol: a review of basic mechanisms and clinical uses","volume":"36","author":"Kherallah","year":"2022","journal-title":"Cardiovasc Drugs Ther"},{"key":"2026051402265956100_oeag068-B5","doi-asserted-by":"crossref","first-page":"88","DOI":"10.2459\/JCM.0b013e3283439746","article-title":"Effects of cilostazol in the heart","volume":"12","author":"Kanlop","year":"2011","journal-title":"J Cardiovasc Med (Hagerstown)"},{"key":"2026051402265956100_oeag068-B6","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0002-9149(01)01719-2","article-title":"Analysis of the cilostazol safety database","volume":"87","author":"Pratt","year":"2001","journal-title":"Am J Cardiol"},{"key":"2026051402265956100_oeag068-B7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1054\/JCPT.2000.8696","article-title":"Chronotropic effects of cilostazol in patients with chronic atrial fibrillation and bradycardia","volume":"5","author":"Toyonaga","year":"2000","journal-title":"J Cardiovasc Pharmacol Ther"}],"container-title":["European Heart Journal Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjopen\/advance-article-pdf\/doi\/10.1093\/ehjopen\/oeag068\/68172219\/oeag068.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/2\/oeag068\/68172219\/oeag068.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjopen\/article-pdf\/6\/2\/oeag068\/68172219\/oeag068.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:27:03Z","timestamp":1778740023000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjopen\/article\/doi\/10.1093\/ehjopen\/oeag068\/8663701"}},"subtitle":[],"editor":[{"given":"Magnus","family":"B\u00e4ck","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":7,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjopen\/oeag068","relation":{},"ISSN":["2752-4191"],"issn-type":[{"value":"2752-4191","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,3]]},"article-number":"oeag068"}}