Impact of Ventricular Rate Control on the Prognosis of Patients with Heart Failure and Atrial Fibrillation with Decreased Ejection Fraction

LUO Hao; XIA Xue; XIONG Wenjin

doi:10.16458/j.cnki.1007-0893.2025.04.009

Abstract：Objective To explore the influence of the control level of ventricular rate on the prognosis of patients with heart failure with decreased ejection fraction(HFrEF)accompanied by atrial fibrillation(referred to as"AF"for short).Methods A total of 106 patients with HFrEF accompanied by atrial fibrillation admitted to the Affiliated Hospital of Xinyang Vocational and Technical College from January 2022 to April 2023 were selected and divided into a control group and an observation group using the random number table method,with 53 cases in each group.The ventricular rate of patients in the control group was controlled at 80～99 beats·min-1,while that of patients in the observation group was controlled at 60～79 beats·min-1.The clinical symptoms,cardiac function,6-minute walking distance,N-terminal pro-brain natriuretic peptide(NT-proBNP)level,quality of life and 1-year fatality rate of the two groups of patients were compared.Results The clinical symptoms of patients in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the values of left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)in both groups were lower than those before treatment,and the left ventricular ejection fraction(LVEF)was higher than that before treatment.Moreover,the values of LVEDD and LVESD in the observation group were lower than those in the control group,and the LVEF was higher than that in the control group.The differences were all statistically significant(P<0.05).The 6-minute walking distance of the two groups of patients after treatment was longer than that before treatment,and the observation distance was longer than that of the control group.The difference was statistically significant(P<0.05).After treatment,the NT-proBNP levels of patients in both groups were lower than those before treatment,and the levels of patients in the observation group were lower than those in the control group.The difference was statistically significant(P<0.05).After the treatment,the scores of physiological function,general health,physical pain,etc.of the patients in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).After a 1-year follow-up,the fatality rate of patients in the observation group was 14.00%,which was lower than 31.25%in the control group,and the difference was statistically significant(P<0.05).Conclusion Controlling the ventricular rate of patients with HFrEF accompanied by atrial fibrillation at 60-79 beats·min-1 is more helpful than 80-99 beats·min-1 in improving the clinical symptoms,cardiac function,quality of life and prognosis of patients.