Comparison of Rate Assessment between Resting Heart Rate and 24-Hour Holter Monitoring in Patients with Chronic Atrial Fibrillation
Akanis Srisukwattana MD*, Rungroj Krittayaphong MD*
Affiliation : * Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Target heart rate in rate control strategy has been proposed by the Atrial Fibrillation Follow-up Investigation
of Rhythm Management (AFFIRM) study. There is limited data on the correlation of measured heart rate at rest and during
Holter monitoring.
Objective : To evaluate the proportion of achieved target heart rate between resting heart rate measuring and 24-hour Holter
monitoring in patients with chronic atrial fibrillation who receive rate control strategy.
Material and Method: Patients with chronic atrial fibrillation who archived target resting heart rate under rate control
strategy at Siriraj Hospital and who underwent 24-hour Holter monitoring were studied to evaluate the correlation between
two methods of heart rate control.
Results : 47 patients were enrolled. Underlying cardiac conditions were as follows: hypertensive heart disease 44.7%,
valvular heart disease 25%, coronary artery disease 17% and dilated cardiomyopathy 12.8%. There were 10 patients
(21.3%) whose achieving target resting heart rate was not correlated with 24-hour Holter monitoring. Three patients (6.4%)
underwent permanent pacemaker implantation due to sick sinus syndrome (SSS) or tachycardia-bradycardia syndrome.
Conclusion : In chronic atrial fibrillation patients that receive rate control strategy, evaluation of only resting heart rate might
not be enough for long-term evaluation and treatment and 24-hour monitoring may be an additional helpful test in order to
more precisely adjust medication for long-term treatment and detection of SSS.
Keywords : Rate control, Atrial fibrillation, Holter monitoring
