Good News Guidelines: When Less is Better

New medical guidelines often mean more to worry about, not less, but sometimes the opposite is true. New guidelines released on December 20 by the American College of Cardiology Foundation, the American Heart Association, and the Heart Rhythm Society allow doctors and patients to be more lenient about heart rate control in atrial fibrillation patients.

courtesy of flickr user RW PhotoBug (creative commons)

 According to a press release issued jointly by the three organizations, approximately 2 million Americans live with atrial fibrillation. The previous recommendations called for keeping patients’ heart rates below 80 beats per minute at rest and less than 110 beats per minute during a 6-minute walk. The updated guidelines are based on recent evidence showing that strict control doesn’t appear to benefit patients. Therefore, the new guidelines advise patients with persistent atrial fibrillation and stable functioning ventricles to achieve a resting heart rate of less than 110 beats per minute.

The good news about these guidelines: Less stress about absolute numbers.

 Dr. Anne Curtis of the University of Buffalo, a member of the writing group for the update, said in an interview that the study on which the heart rate recommendation was based was too small to show a significant difference in clinical outcomes for patients who were randomized to strict heart rate control vs. more lenient control. “Nevertheless, strict targeting of treatment to achieve an arbitrary heart rate seems unnecessary,” the writing group said in the document.  

Ideally, the news that they have a little less to be strict about will be a holiday gift for atrial fibrillation patients and their doctors.

–Heidi Splete (on twitter @hsplete)

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Filed under Cardiovascular Medicine, Family Medicine, IMNG, Internal Medicine

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