Atrial fibrillation and congestive heart failure: a two-way street.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical cardiology, particularly in patients with heart failure. Its prevalence increases with the degree of left ventricular dysfunction and severity of heart failure symptoms. The development of AF in the setting of heart failure has been shown to result in increased mortality. Studies thus far indicate that rhythm control with antiarrhythmic drug therapy or catheter ablation offers both symptomatic and probably survival advantage in patients with heart failure and AF. In patients with permanent AF, the effects of restoring a regular ventricular response with atrioventricular junction ablation followed by biventricular pacing remain to be shown. In the current manuscript, we will review the proposed mechanisms of increased morbidity and mortality associated with AF and the current treatment options including the roles of radiofrequency ablation and pacing.
Akoum
Nazem
N
University of Utah, 30 North 1400 East, Room 4A100, Salt Lake City, UT 84132, USA.
Hamdan
Mohamed H
MH
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D015994:Incidence; D018487:Ventricular Dysfunction, Left / Q000150:complications
D000889:Anti-Arrhythmia Agents