Prevalence, prognostic significance, and treatment of atrial fibrillation in congestive heart failure with particular reference to the DIAMOND-CHF study.
Atrial fibrillation is a growing health problem and the most common cardiac arrhythmia, affecting 5% of persons above the age of 65 years. The number of hospital discharges for atrial fibrillation has more than doubled in the past decade. It occurs very often in patients with congestive heart failure and the prevalence increases with the severity of the disease. These two conditions seem to be linked together, and congestive heart failure may either be the cause or the consequence of atrial fibrillation. The prognosis of atrial fibrillation is controversial, but studies indicate that atrial fibrillation is a risk factor in congestive heart failure patients. In the last 10-15 years, significant advances in the treatment of heart failure have improved survival, whereas effective management of atrial fibrillation in heart failure patients still awaits similar progress. Empirically, two strategies have evolved for treatment of atrial fibrillation: 1) rhythm control, which means conversion to sinus rhythm and maintenance of sinus rhythm; and 2) rate control, which means reduction of heart rate to an acceptable frequency. It is unknown whether one of these strategies is better than the other. In this review the authors discuss the prevalence, impact, and treatment of atrial fibrillation in heart failure patients.
Pedersen
Ole Dyg
OD
Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark. odplc@mail.dk
Brendorp
Bente
B
Køber
Lars
L
Torp-Pedersen
Christian
C
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000188:drug therapy / Q000401:mortality; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016275:Atrial Function / Q000187:drug effects / Q000502:physiology; D003718:Denmark; D004562:Electrocardiography; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D010627:Phenethylamines / Q000627:therapeutic use*; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D013449:Sulfonamides / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D000889:Anti-Arrhythmia Agents; D010627:Phenethylamines; D013449:Sulfonamides; C063533:dofetilide