Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis
Abstract Background Rate control is a primary treatment approach for managing atrial fibrillation (AF). However, a unified standard for the optimal level of control remains unestablished. This study aimed to investigate the impact of strict versus lenient heart rate control strategies on exercise ca...
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BMC
2025-07-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04961-9 |
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| author | Jinna Chang Qian Du Yuting Liu Dujuan Li Haofeng Zhou Yingxue Liao Junshuo Zhu Bingqing Bai Xiangyang Liu Huan Ma |
| author_facet | Jinna Chang Qian Du Yuting Liu Dujuan Li Haofeng Zhou Yingxue Liao Junshuo Zhu Bingqing Bai Xiangyang Liu Huan Ma |
| author_sort | Jinna Chang |
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| description | Abstract Background Rate control is a primary treatment approach for managing atrial fibrillation (AF). However, a unified standard for the optimal level of control remains unestablished. This study aimed to investigate the impact of strict versus lenient heart rate control strategies on exercise capacity in patients with AF by assessing cardiopulmonary exercise test (CPET) results. Methods A total of 693 patients with AF were included in this study. The patients were categorized into three groups on the basis of their resting heart rate: strict rate control (resting heart rate < 80 beats per minute and heart rate during moderate exercise < 110 beats per minute), lenient rate control (resting heart rate < 110 beats per minute), and uncontrolled rate (resting heart rate ≥ 110 beats per minute. CPET indicators were compared across the different rate control strategies, and trend analyses were conducted to explore whether there was a correlation between heart rate control and exercise capacity. Results Significant differences in the maximum load, respiratory exchange ratio (RER), peak oxygen uptake (peak VO2), peak oxygen pulse, and ventilatory equivalent (VE/VCO2) at the anaerobic threshold were detected among the groups in the strict control, lenient control, and uncontrolled groups (all p < 0,05). However, no significant differences were detected in the anaerobic threshold or ventilation parameters among these groups. Trend analyses indicated that stricter heart rate control was associated with significant increases in maximum workload, peak VO2, peak oxygen pulse, and ventilatory equivalent. Conclusion In patients with AF, strict heart rate control may enhance exercise capacity, suggesting the importance of effective heart rate management strategies. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-d28331a487b343a89b98d8bb5ddb32be2025-08-20T03:42:23ZengBMCBMC Cardiovascular Disorders1471-22612025-07-012511810.1186/s12872-025-04961-9Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysisJinna Chang0Qian Du1Yuting Liu2Dujuan Li3Haofeng Zhou4Yingxue Liao5Junshuo Zhu6Bingqing Bai7Xiangyang Liu8Huan Ma9Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Cardiology, Guangzhou Red Cross Hospital, Medical College, Jinan UniversityThe Second Clinical College of Jinan University, Shenzhen People’s HospitalDepartment of Rehabilitation Medicine, The Second Affiliated Hospital of Wannan Medical CollegeGuangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesGuangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesGuangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Cardiology, Yuebei People’s Hospital Affiliated to Shantou University Medical CollegeGuangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesAbstract Background Rate control is a primary treatment approach for managing atrial fibrillation (AF). However, a unified standard for the optimal level of control remains unestablished. This study aimed to investigate the impact of strict versus lenient heart rate control strategies on exercise capacity in patients with AF by assessing cardiopulmonary exercise test (CPET) results. Methods A total of 693 patients with AF were included in this study. The patients were categorized into three groups on the basis of their resting heart rate: strict rate control (resting heart rate < 80 beats per minute and heart rate during moderate exercise < 110 beats per minute), lenient rate control (resting heart rate < 110 beats per minute), and uncontrolled rate (resting heart rate ≥ 110 beats per minute. CPET indicators were compared across the different rate control strategies, and trend analyses were conducted to explore whether there was a correlation between heart rate control and exercise capacity. Results Significant differences in the maximum load, respiratory exchange ratio (RER), peak oxygen uptake (peak VO2), peak oxygen pulse, and ventilatory equivalent (VE/VCO2) at the anaerobic threshold were detected among the groups in the strict control, lenient control, and uncontrolled groups (all p < 0,05). However, no significant differences were detected in the anaerobic threshold or ventilation parameters among these groups. Trend analyses indicated that stricter heart rate control was associated with significant increases in maximum workload, peak VO2, peak oxygen pulse, and ventilatory equivalent. Conclusion In patients with AF, strict heart rate control may enhance exercise capacity, suggesting the importance of effective heart rate management strategies.https://doi.org/10.1186/s12872-025-04961-9Atrial fibrillationExercise capacityHeart rate controlCardiopulmonary exercise testPeak oxygen uptake |
| spellingShingle | Jinna Chang Qian Du Yuting Liu Dujuan Li Haofeng Zhou Yingxue Liao Junshuo Zhu Bingqing Bai Xiangyang Liu Huan Ma Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis BMC Cardiovascular Disorders Atrial fibrillation Exercise capacity Heart rate control Cardiopulmonary exercise test Peak oxygen uptake |
| title | Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis |
| title_full | Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis |
| title_fullStr | Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis |
| title_full_unstemmed | Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis |
| title_short | Effects of strict versus lenient rate control on exercise capacity in atrial fibrillation: a retrospective analysis |
| title_sort | effects of strict versus lenient rate control on exercise capacity in atrial fibrillation a retrospective analysis |
| topic | Atrial fibrillation Exercise capacity Heart rate control Cardiopulmonary exercise test Peak oxygen uptake |
| url | https://doi.org/10.1186/s12872-025-04961-9 |
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