Heart rate as a therapeutic target in heart failure?

A common finding in all clinical trials on heart failure is a negative correlation between heart rate and duration of life. In several studies this was found in both patients taking and those not taking beta-blocker agents. In postinfarct patients increasing mortality with increasing heart rate was found in the absence and in the presence of left ventricular dysfunction. Moreover beneficial effects of neurohormonal modulators were found to be greater in heart failure patients with higher heart rate. Thus heart rate can be considered a target for medical intervention, and therapeutic attempts focused on direct control of heart rate have a good rationale. (C) 2003 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.