{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:24:50Z","timestamp":1792686290609,"version":"4.5.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,9,16]]},"abstract":"\n Background<\/jats:title>\n \n Most patients with atrial fibrillation (\n AF<\/jats:styled-content>\n ) require rate control; however, the optimal target heart rate remains under debate. We aimed to assess rate control and subsequent outcomes among patients with permanent\n AF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We studied 2812\n US<\/jats:styled-content>\n outpatients with permanent\n AF<\/jats:styled-content>\n in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation. Resting heart rate was measured longitudinally and used as a time\u2010dependent covariate in multivariable Cox models of all\u2010cause and cause\u2010specific mortality during a median follow\u2010up of 24\u00a0months. At baseline, 7.4% (n=207) had resting heart rate <60\u00a0beats per minute (bpm), 62% (n=1755) 60 to 79\u00a0bpm, 29% (n=817) 80 to 109\u00a0bpm, and 1.2% (n=33) \u2265110\u00a0bpm. Groups did not differ by age, previous cerebrovascular disease, heart failure status,\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010\n VAS<\/jats:styled-content>\n c scores, renal function, or left ventricular function. There were significant differences in race (\n P<\/jats:italic>\n =0.001), sinus node dysfunction (\n P<\/jats:italic>\n =0.004), and treatment with calcium\u2010channel blockers (\n P<\/jats:italic>\n =0.006) and anticoagulation (\n P<\/jats:italic>\n =0.009). In analyses of continuous heart rates, lower heart rate \u226465\u00a0bpm was associated with higher all\u2010cause mortality (adjusted hazard ratio [\n HR<\/jats:styled-content>\n ], 1.15 per 5\u2010bpm decrease; 95%\n CI<\/jats:styled-content>\n , 1.01 to 1.32;\n P<\/jats:italic>\n =0.04). Similarly, increasing heart rate >65\u00a0bpm was associated with higher all\u2010cause mortality (adjusted\n HR<\/jats:styled-content>\n , 1.10 per 5\u2010bpm increase; 95%\n CI<\/jats:styled-content>\n , 1.05 to 1.15;\n P<\/jats:italic>\n <0.0001). This relationship was consistent across endpoints and in a broader sensitivity analysis of permanent and nonpermanent\n AF<\/jats:styled-content>\n patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Among patients with permanent\n AF<\/jats:styled-content>\n , there is a J\u2010shaped relationship between heart rate and mortality. These data support current guideline recommendations, and clinical trials are warranted to determine optimal rate control.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n . Unique identifier: NCT01165710.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002031","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T01:40:37Z","timestamp":1442281237000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Increased Heart Rate Is Associated With Higher Mortality in Patients With Atrial Fibrillation (AF): Results From the Outcomes Registry for Better Informed Treatment of AF (ORBIT\u2010AF)"],"prefix":"10.1161","volume":"4","author":[{"given":"Benjamin A.","family":"Steinberg","sequence":"first","affiliation":[{"name":"Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunghee","family":"Kim","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laine","family":"Thomas","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"UCLA Division of Cardiology, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard J.","family":"Gersh","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Holmqvist","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Hylek","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Kowey","sequence":"additional","affiliation":[{"name":"Lankenau Institute for Medical Research, Wynnewood, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth W.","family":"Mahaffey","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Naccarelli","sequence":"additional","affiliation":[{"name":"Penn State University School of Medicine, Hershey, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Reiffel","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Chang","sequence":"additional","affiliation":[{"name":"Janssen Pharmaceuticals, Inc., Raritan, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Piccini","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC"},{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT\u2010AF) Investigators and Patients","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.07.022"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.8.983"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021375"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021328"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.12.019"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001337"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1002301"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs253"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000041"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.07.001"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"key":"e_1_3_4_13_2","first-page":"751","article-title":"Quality of care, symptoms, and 1\u00a0year outcomes for women vs men with atrial fibrillation: primary results from the ORBIT\u2010AF registry","author":"Piccini JP","year":"2013","unstructured":"Piccini JP, Kim S, Steinberg BA, Holmes D, Ansell J, Fonarow G, Gersh B, Hylek E, Kowey PR, Mahaffey KW, Thomas L, Chang P, Peterson E. 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J Am Coll Cardiol. 2013; Abstract: 751\u2013758.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002927"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000180580"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31820f14c0"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90836-2"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.04.030"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eul106"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.02.033"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.002031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:11:49Z","timestamp":1715595109000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.002031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,16]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2015,9,16]]}},"alternative-id":["10.1161\/JAHA.115.002031"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.002031","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,16]]},"assertion":[{"value":"2015-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e002031"}}