The Effect of Rate Control on Quality of Life in Patients With Permanent Atrial Fibrillation
Open accessAbstract
Objectives The aim of this study was to investigate the influence of rate control on quality of life (QOL).Background The RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation II) trial showed that lenient rate control is not inferior to strict rate control in terms of cardiovascular morbidity and mortality. The influence of stringency of rate control on QOL is unknown.Methods In RACE II, a total of 614 patients with permanent atrial fibrillation (AF) were randomized to lenient (resting heart rate [HR] <110 beats/min) or strict (resting HR <80 beats/min, HR during moderate exercise <110 beats/min) rate control. QOL was assessed in 437 patients using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire, AF severity scale, and Multidimensional Fatigue Inventory-20 (MFI-20) at baseline, 1 year, and end of study. QOL changes were related to patient characteristics.Results Median follow-up was 3 years. Mean age was 68 ± 8 years, and 66% were males. At the end of follow-up, all SF-36 subscales were comparable between both groups. The AF severity scale was similar at baseline and end of study. At baseline and at end of study there were no differences in the MFI-20 subscales between the 2 groups. Symptoms at baseline, younger age, and less severe underlying disease, rather than assigned therapy or heart rate, were associated with QOL improvements. Female sex and cardiovascular endpoints during the study were associated with worsening of QOL.Conclusions Stringency of heart rate control does not influence QOL. Instead, symptoms, sex, age, and severity of the underlying disease influence QOL. (Rate Control Efficacy in Permanent Atrial Fibrillation; NCT00392613).
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In the RACE II study, there was no difference in a composite of clinical events (14.9% in the strict rate control group, 12.9% in the lenient group), NYHA class, or hospitalizations.
“There was no difference in a composite of clinical events (14.9% in the strict rate control group, 12.9% in the lenient group), 560 NYHA class, or hospitalizations.560, 561”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [561]
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- Authors
- Groenveld, H. F., Crijns, H. J. G. M., Van den Berg, M. P., Van Sonderen, E., Alings, A. M., Tijssen, J. G. P., Hillege, H. L., Tuininga, Y. S., Van Veldhuisen, D. J., Ranchor, A. V., & Van Gelder, I. C.
- Affiliations
- University Medical Center Groningen (NL)
- Maastricht University Medical Centre (NL)
- University of Amsterdam (NL)
- Deventer Ziekenhuis (NL)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-10
- Volume
- 58
- Issue
- 17
- Pages
- 1795-1803
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1531214291
- Cited by
- 164
- References
- 39
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 7 · 2023: 11 · 2022: 12 · 2021: 13 · 2020: 14 · 2019: 6 · 2018: 5 · 2017: 15 · 2016: 14 · 2015: 9 · 2014: 16 · 2013: 12 · 2012: 14
- FWCI
- 9.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Pure Amsterdam UMC (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (acceptedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Netherlands Heart Foundation (2003B118)
- Medtronic
- Biotronik
- St. Jude Medical
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- permanent atrial fibrillation, rate control, quality of life, resting heart rate, fatigue, SF-36, Multidimensional Fatigue Inventory, sex differences, age
- MeSH terms
- Adrenergic beta-Antagonists, Aged, Atrial Fibrillation, Calcium Channel Blockers, Cardiovascular Agents, Digoxin, Female, Follow-Up Studies, Heart Rate, Humans, Male, Middle Aged, Quality of Life
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