Arrhythmias & electrophysiologyResearch article
Heart rate in early rhythm control therapy in patients with atrial fibrillation
- Early Treatment of Atrial Fibrillation for Stroke Prevention Trial analysis
Authors' conclusion
A high heart rate (≥110 beats per minute) during AF is associated with more and more severe AF-related symptoms. Cardiovascular event rates are not different between heart rates. Early rhythm control reduces outcomes in patients with high and low heart rates during AF.
Study context
- Population
- Patients in atrial fibrillation (AF) at baseline with information on heart rate availablepatients in AF at baseline with information on heart rate available
- Participants
- 772 patients
- Comparison
- patients with a heart rate <110 beats per minute and ≥110 beats per minute at baseline
- heart rate <110 beats per minuten = 506reference
- Outcome
- composite of:
- Death from cardiovascular causes
- Stroke or hospitalisation with worsening of heart failure or acute coronary syndrome
Main finding
As reported in the abstract
Hazard ratio
1.08
95% CI 0.79–1.48
Events by group
heart rate <110 beats per minute
5.1 per 100 person-years
116 of 506
heart rate ≥110 beats per minute
5.1 per 100 person years
62 events
heart rate ≥110 beats per minute vs heart rate <110 beats per minute
HR 1.08 (95% CI 0.79–1.48)
Further findings
Symptomatic AF · baseline
Severe symptomatic AF (European Heart Rhythm Association score ≥3) · baseline
- Symptomatic AF: p<0.001
- Severe symptomatic AF (European Heart Rhythm Association score ≥3): p=0.032
Baseline characteristics
- Mean age
- 70.8±7.8 years
- Women
- 305 (40%)
- Randomised to early rhythm control
- 385 (50%)
Original publication
Heart rate in early rhythm control therapy in patients with atrial fibrillation. Heart. Published 9 February 2026. doi:10.1136/heartjnl-2025-326878
Summarised from the published abstract; every number is checked against it