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Comparative Study
. 2024 Jul;29(4):e13128.
doi: 10.1111/anec.13128.

The heart rate response to the 6-min walk test in atrial fibrillation patients with or without beta-blockers: Referring to patients with sinus rhythm

Feng Xie  1 , Zhenzhen Jiang  2 , Bo Zhu  1 , Juxiang Li  1 , Yanqing Wu  1 , Hai Su  1
Affiliations
Comparative Study

The heart rate response to the 6-min walk test in atrial fibrillation patients with or without beta-blockers: Referring to patients with sinus rhythm

Feng Xie et al. Ann Noninvasive Electrocardiol. 2024 Jul.

Abstract

Background: The aim was to evaluate the effect of beta-blockers (BB) on the response of heart rate (HR) to 6-min walk test (6MWT) in atrial fibrillation (AF) and whether the AF patients treated with BB have a similar HR response to 6MWT as the AF and sinus rhythm (SR) patients without BB treatment at the same resting HR level.

Methods: The before-after study involving 74 AF patients was to evaluate the effect of BB treatment (pre-BB and with BB). The comparison study included 74 BB-treated AF patients (with BB), 74 matched AF patients without BB (no BB), and 74 SR patients. The percentage increase amplitude of HR (HR-PIA) in 6MWT was calculated: [(the exercise HR - the resting HR)/(the resting HR)] × 100%.

Results: The before-after study showed that BB treatment decreased the resting and mean exercise HR (98.6 ± 15.2 vs. 85.5 ± 11.2 bpm and 121.3 ± 17.3 vs. 109.0 ± 16.7 bpm) during 6MWT. The comparison study demonstrated that against the SR, the AF with BB and no BB groups have higher mean exercise HR-PIA (28.2 ± 17.1% and 22.0 ± 9.6%, vs. 6.9 ± 3.7%) when their resting HR is similar. Moreover, the mean exercise HR-PIA was also significantly higher in the with BB group than in the no BB group.

Conclusion: In AF patients with relatively higher resting HR, BB treatment could decrease the resting and exercise HR during 6MWT. However, BB treatment could not effectively attenuate the exercise HR rise as compared with AF without BB treatment, even with similar resting HR levels.

Keywords: 6‐min walk test; atrial fibrillation; beta‐blockers; exercise; heart rate.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The control design of this study. The before–after study was the comparison of exercise HR profiles during 6MWT in 74 AF patients before (pre‐BB AF) and after (with BB AF) BB treatment. The inter‐group comparison study was the comparison of exercise HR profiles during 6MWT in the AF with BB and no BB groups and the SR group. AF, atrial fibrillation; BB, beta‐blockers; SR, sinus rhythm.
FIGURE 2
FIGURE 2
The comparison of the HR curves in different groups. (a) Comparison between the pre‐BB and with BB conditions. *Compared with the same item of the pre‐BB AF group, p < .05. (b) Comparison among the AF with BB and no BB groups and the SR group. †Compared with the same item of the no BB AF group, p < .05. AF, atrial fibrillation; BB, beta‐blockers; SR, sinus rhythm.
FIGURE 3
FIGURE 3
The comparison of exercise HR‐PIA in three groups at different HR levels. (a) Mean exercise HR‐PIA; (b) Maximal exercise HR‐PIA. *Compared with the same item of the HR ≥90 bpm subgroup, p < .05. BB, beta‐blockers; HR‐PIA, the percentage of heart rate increase amplitude; SR, sinus rhythm.
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References

    1. Aihara, K. , Kato, Y. , Suzuki, S. , Arita, T. , Yagi, N. , Semba, H. , Kano, H. , Matsuno, S. , Otsuka, T. , Uejima, T. , Oikawa, Y. , Kunihara, T. , Yajima, J. , & Yamashita, T. (2018). Prognostic value of the heart rate profile during exercise in patients with atrial fibrillation. European Journal of Preventive Cardiology, 25(15), 1634–1641. 10.1177/2047487318797398 - DOI - PubMed
    1. Atwood, J. E. , Sullivan, M. , Forbes, S. , Myers, J. , Pewen, W. , Olson, H. G. , & Froelicher, V. F. (1987). Effect of beta‐adrenergic blockade on exercise performance in patients with chronic atrial fibrillation. Journal of the American College of Cardiology, 10(2), 314–320. 10.1016/s0735-1097(87)80013-x - DOI - PubMed
    1. Corino, V. D. , Sandberg, F. , Platonov, P. G. , Mainardi, L. T. , Ulimoen, S. R. , Enger, S. , Tveit, A. , & Sörnmo, L. (2014). Non‐invasive evaluation of the effect of metoprolol on the atrioventricular node during permanent atrial fibrillation. Europace, 16, iv129–iv134. 10.1093/europace/euu246 - DOI - PubMed
    1. Farshi, R. , Kistner, D. , Sarma, J. S. , Longmate, J. A. , & Singh, B. N. (1999). Ventricular rate control in chronic atrial fibrillation during daily activity and programmed exercise: A crossover open‐label study of five drug regimens. Journal of the American College of Cardiology, 33(2), 304–310. 10.1016/s0735-1097(98)00561-0 - DOI - PubMed
    1. Jaber, J. , Cirenza, C. , Amaral, A. , Jaber, J. , Oliveira Filho, J. A. , & de Paola, A. A. (2011). Correlation between heart rate control during exercise and exercise capacity in patients with chronic atrial fibrillation. Clinical Cardiology, 34(9), 533–536. 10.1002/clc.20948 - DOI - PMC - PubMed

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