RT Journal Article SR Electronic T1 Heart rate and adverse outcomes in patients with prevalent atrial fibrillation JF Open Heart JO Open Heart FD British Cardiovascular Society SP e001606 DO 10.1136/openhrt-2021-001606 VO 8 IS 1 A1 Giorgio Moschovitis A1 Linda S B Johnson A1 Steffen Blum A1 Stefanie Aeschbacher A1 Maria Luisa De Perna A1 Alberto Pagnamenta A1 Patrizia Assunta Mayer Melchiorre A1 Alexander P Benz A1 Richard Kobza A1 Marcello Di Valentino A1 Christine S Zuern A1 Angelo Auricchio A1 Giulio Conte A1 Nicolas Rodondi A1 Manuel R Blum A1 Juerg H Beer A1 Michael Kühne A1 Stefan Osswald A1 David Conen A1 , YR 2021 UL http://openheart.bmj.com/content/8/1/e001606.abstract AB Objective The optimal target heart rate in patients with prevalent atrial fibrillation (AF) is not well defined. The aim of this study was to analyse the associations between heart rate and adverse outcomes in a large contemporary cohort of patients with prevalent AF.Methods From two prospective cohort studies, we included stable AF outpatients who were in AF on the baseline ECG. The main outcome events assessed during prospective follow-up were heart failure hospitalisation, stroke or systemic embolism and death. The associations between heart rate and adverse outcomes were evaluated using multivariable Cox regression models.Results The study population consisted of 1679 patients who had prevalent AF at baseline. Mean age was 74 years, and 24.6% were women. The mean heart rate on the baseline ECG was 78 (±19) beats per minute (bpm). The median follow-up was 3.9 years (IQR 2.2–5.0). Heart rate was not significantly associated with heart failure hospitalisation (adjusted HR (aHR) per 10 bpm increase, 1.00, 95% CI 0.94 to 1.07, p=0.95), stroke or systemic embolism (aHR 0.95, 95% CI 0.84 to 1.07, p=0.38) or death (aHR 1.02, 95% CI 0.95 to 1.09, p=0.66). There was no evidence of a threshold effect for heart rates <60 bpm or >100 bpm.Conclusions In this large contemporary cohort of outpatients with prevalent AF, we found no association between heart rate and adverse outcome events. These data are in line with recommendations that strict heart rate control is not needed in otherwise stable outpatients with AF.No data are available.