Atrial Fibrillation in Heart Failure-Diagnostic, Therapeutic, and Prognostic Relevance

Curr Heart Fail Rep. 2019 Aug;16(4):108-115. doi: 10.1007/s11897-019-00430-5.

Abstract

Purpose of review: Atrial fibrillation (AF) and heart failure (HF) commonly coexist and are associated with an increased risk of hospitalization, morbidity, and mortality. Both conditions develop into epidemics due to the ageing of the population and lead to poorer prognosis for the individual patients. Therapeutic strategies include treatment with oral anticoagulation, and rate and rhythm control concepts to prevent stroke and improve the cardiovascular outcome.

Recent findings: Especially in HF patients, data suggest that catheter ablation of AF is superior to medical treatment. In patients with both AF and HF undergoing catheter ablation, significant increases in left ventricular ejection fraction and quality of life and decreases in related symptoms and major adverse cardiac events are reported. In addition, catheter ablation has been shown to reduce mortality and HF hospitalization in the medium term. For patients with AF and HF, an effective individualized therapeutic strategy to minimize potential complications and improve clinical outcomes is needed. Catheter ablation of AF seems to provide advantages in HF patients with AF. However, results of further long-term studies are awaited.

Keywords: Atrial fibrillation; Catheter ablation; Heart failure; Rate control; Rhythm control.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / therapy*
  • Catheter Ablation*
  • Heart Failure / diagnosis
  • Heart Failure / therapy*
  • Hospitalization
  • Humans
  • Prognosis
  • Quality of Life
  • Stroke / prevention & control
  • Stroke Volume
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents