Management of heart rate in heart failure
José Luis Barisani

The association between increased heart rate (HR) and cardiovascular events is well known for the general population, as for all heart diseases. In heart failure with reduced ejection fraction and sinus rhythm, HR is a modifiable risk factor. Its reduction to values that have been shown to improve prognosis should be a therapeutic objective. We discuss what the optimal HR value should be in patients with chronic heart failure and in the vulnerable phase of the hospitalized patient for acute heart failure. The synergism between beta-blockers and ivabradine can be a useful therapeutic option in these cases. In patients with atrial fibrillation, however, there is no conclusive evidence demonstrating evolutionary changes with the HR control.

Keywords: Heart failure - Heart rate - Beta-blockers - Ivabradine - Vulnerable phase - Atrial fibrillation