Atrial fibrillation in heart failure: prognostic significance and management.
AF in Heart Failure. Atrial fibrillation and congestive heart failure are commonly occurring cardiac disorders that often exist concomitantly. The prognostic significance of the presence or absence of atrial fibrillation, as an independent risk factor, in patients with heart failure remains controversial. Antiarrhythmic drugs with good hemodynamic profiles and neutral effects on survival are preferred treatments for converting atrial fibrillation and maintaining sinus rhythm. Other standard therapies for congestive heart failure, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and beta-blockers also have a role in the treatment of these coexisting disease states. The article presents an overview of atrial fibrillation in patients with heart failure and reviews the prevalence, prognostic significance, and efficacy of various antiarrhythmic agents for the conversion and maintenance of sinus rhythm.
Division of Cardiology and the Penn State Cardiovascular Center, Penn State College of Medicine, Hershey, Pennsylvania 17033, USA. gnaccarelli@psu.edu
Gerald V
GV
Naccarelli
B John
BJ
Hynes
Deborah L
DL
Wolbrette
Luna
L
Bhatta
Mazhar
M
Khan
Soraya
S
Samii
Jerry C
JC
Luck
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D010346:Patient Care Management / Q000379:methods*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents