Title: How to control heart rate in patients with atrial fibrillation? The role of 24 hour ECG Holter monitoring
- Michał Chudzik, Jerzy Krzysztof Wranicz, Artur Klimczak, Iwona Cygankiewicz, Jan Henryk Goch
- Review articles
- Polish Journal of Cardiology
- Start page:
- Final page:
- atrial fibrillation, controlling of ventricular rate, tachycardiomyopathy, ventricular rate irregularity
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia. Rate control as the first line therapy for the patients with AF has been confirmed in many studies. However, the questions which is the correct ventricular rate and what parameters should be estimated, still are opened. Nowdays, it seems that monitoring of the mean heart rate (mHR) in 24 hour ECG Holter monitoring (24HM) to be the gold standard incomplete assessment of patients with AF. If one is to embark on achieving rate control, it is essential to adequately define this term. Unfortunately, few evidence-based data are available to guide the clinician, and many published definitions of rate control are some what arbitrary. Among many parameters to control ventricular rate, the mean heart rate - 90 bpm - obtained from 24-hours ECG Holter monitoring is one of best known (24HM). According to ACC/AHA/ESC guidelines one day mean heart rate (mHR) in 24HM - 90 bpm is the major established parameters for ventricular rate controlling in AF patients. Correct ventricular rate controlling is such important because longlasting fast or irregular rate can lead to tachycardia induced cardiomyopathy. Unfortunately, sometimes in patients with correct mean heart rate tachy AF episodes and significant irregularity can occure. That is why for correct heart rate controlling not only mean HR but also tachy AF epiosodes as well as irregularity should be estimated.