open access

Online first
Original article
Published online: 2021-09-09
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Pulse deficit in atrial fibrillation — a different perspective on rhythm or rate control strategy

Serhat Karadavut, Ismail Altintop
DOI: 10.33963/KP.a2021.0107
·
Pubmed: 34506629

open access

Online first
Original article
Published online: 2021-09-09

Abstract

Background: Pulse deficit (PD) is a frequently unused but crucial clinical finding in atrial fibrillation (AF) diagnosis.
Aims: The authors aimed to investigate the relationship between PD and exercise intolerance in AF patients for remodeling the treatment in case of a favorable outcome.
Methods: This prospective study was conducted with 273 persistent AF patients between September 2019 and October 2020. An exercise stress test stratified by age and sex-matched was performed to determine exercise intolerance, and the patients were divided into 2 groups based on physical capacity: low (<75 percentile as Group-1) (n = 160; 58.6%), adequate (≥75 percentile as Group-2) (n = 113; 41.4%).
Results: The mean (standard deviation [SD]) PD of exercise intolerance patients was significantly higher than patients with adequate exercise capacity (17 [4] vs 12 [2]; P <0.001). Moreover, PD was independently associated with exercise intolerance after adjusting for potential covariates (odds radtio [OR], 0.59; 95% CI, 0.51–0.69; P <0.001). In both univariate and multivariable analyses, higher heart rates had a stronger relationship with exercise intolerance (Mean [SD], 107 [11] vs 99 [10]; P <0.001; OR, 0.92; 95% CI, 0.89–0.96; P <0.001). Also, there was a positive correlation between heart rate and PD (r = 0.431; P <0.001).
Conclusions: Increased PD was associated with decreased exercise capacity in persistent AF patients. Rhythm control strategy should be considered to increase left ventricular filling pressures in AF patients with high PD and exercise intolerance.

Abstract

Background: Pulse deficit (PD) is a frequently unused but crucial clinical finding in atrial fibrillation (AF) diagnosis.
Aims: The authors aimed to investigate the relationship between PD and exercise intolerance in AF patients for remodeling the treatment in case of a favorable outcome.
Methods: This prospective study was conducted with 273 persistent AF patients between September 2019 and October 2020. An exercise stress test stratified by age and sex-matched was performed to determine exercise intolerance, and the patients were divided into 2 groups based on physical capacity: low (<75 percentile as Group-1) (n = 160; 58.6%), adequate (≥75 percentile as Group-2) (n = 113; 41.4%).
Results: The mean (standard deviation [SD]) PD of exercise intolerance patients was significantly higher than patients with adequate exercise capacity (17 [4] vs 12 [2]; P <0.001). Moreover, PD was independently associated with exercise intolerance after adjusting for potential covariates (odds radtio [OR], 0.59; 95% CI, 0.51–0.69; P <0.001). In both univariate and multivariable analyses, higher heart rates had a stronger relationship with exercise intolerance (Mean [SD], 107 [11] vs 99 [10]; P <0.001; OR, 0.92; 95% CI, 0.89–0.96; P <0.001). Also, there was a positive correlation between heart rate and PD (r = 0.431; P <0.001).
Conclusions: Increased PD was associated with decreased exercise capacity in persistent AF patients. Rhythm control strategy should be considered to increase left ventricular filling pressures in AF patients with high PD and exercise intolerance.

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Keywords

atrial fibrillation, exercise test, pulse rate

About this article
Title

Pulse deficit in atrial fibrillation — a different perspective on rhythm or rate control strategy

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-09-09

DOI

10.33963/KP.a2021.0107

Pubmed

34506629

Keywords

atrial fibrillation
exercise test
pulse rate

Authors

Serhat Karadavut
Ismail Altintop

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