{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T20:33:47Z","timestamp":1776371627830,"version":"3.51.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>\u03b2-blockers have been recommended for patients with heart failure (HF) and atrial fibrillation (AF), but studies have shown that \u03b2-blockers do not reduce all-cause mortality or cardiovascular mortality in patients with HF and AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the difference in efficacy between oral amiodarone and metoprolol succinate for patients with HF with reduced ejection fraction (HFrEF) and persistent atrial fibrillation (pAF) with rapid ventricular response (RVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with HFrEF complicated with pAF with RVR treated in the People's Hospital of Chongqing Hechuan between March 2018 and March 2019 were enrolled in this prospective observational study. The primary outcomes were cardiovascular mortality and the first hospitalization for HF rate. The secondary outcomes were type B pro-brain natriuretic peptide (NT-proBNP) before\/after treatment, left ventricular ejection fraction (LVEF) before\/after treatment, average heart rate (AhR), and the rate of sinus rhythm after 1 year of follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 242 patients with HFrEF complicated with pAF with RVR were enrolled and divided into amiodarone + perindopril + spironolactone+ routine drug (amiodarone group, <jats:italic>n<\/jats:italic> = 121) and metoprolol succinate + perindopril + spironolactone +routine drug (metoprolol succinate group, <jats:italic>n<\/jats:italic> = 121) according to their treatment strategy. Cardiovascular mortality (4.9 vs. 12.4%, HR: 2.500, 95%CI: 1.002\u20136.237, <jats:italic>P<\/jats:italic> = 0.040) and first hospitalization for HF (52.9 vs. 67.8%, HR: 1.281, 95%CI: 1.033\u20131.589, <jats:italic>P<\/jats:italic> = 0.024) were significantly lower in the amiodarone group than in the metoprolol group. The mean ventricular rate in the amiodarone group was significantly lower than in the metoprolol group (64.5 \u00b1 3.2 vs. 72.4 \u00b1 4.2, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). After 1 year of follow-up, the sinus rhythm rate was significantly higher in the amiodarone group than in the metoprolol group (38.8 vs. 7.4%, HR: 0.191, 95%CI: 0.098\u20130.374, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). The difference in proBNP (3,914.88 vs. 2,558.07, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and LVEF (\u22126.89 vs. \u22120.98, <jats:italic>P<\/jats:italic> &amp;lt; 0.001) before and after treatment was significantly higher in the amiodarone group than in the metoprolol group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, in this prospective observational study, the amiodarone group had lower risk of cardiovascular death and the first hospitalization for HF than metoprolol in HFrEF and persistent atrial fibrillation (pAF) with RVR. The mechanism may be related to improved cardiac function, rhythm control and ventricular rate control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Registration number<\/jats:title><jats:p>ChiCTR2200057816; Registered 7 March 2022\u2013Retrospectively registered: <jats:ext-link>http:\/\/www.medresman.org.cn\/pub\/cn\/proj\/projectshshow.aspx?proj=4222<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.1029012","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T12:33:40Z","timestamp":1673354020000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Amiodarone vs. metoprolol succinate in HFrEF complicated with persistent atrial fibrillation with rapid ventricular response: A prospective observational study"],"prefix":"10.3389","volume":"9","author":[{"given":"Yongrong","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yali","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e147","DOI":"10.1016\/j.jacc.2013.05.019","article-title":"2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines","volume":"62","author":"Yancy","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1016\/S0140-6736(99)04440-2","volume":"353","year":"1999","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S0140-6736(98)11181-9","volume":"353","year":"1999","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1056\/NEJM200105313442201","article-title":"Effect of carvedilol on survival in severe chronic heart failure","volume":"344","author":"Packer","year":"2001","journal-title":"N Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). 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