title: [Treatment of atrial fibrillation in heart failure].
abstract: Treatment of patients with both atrial fibrillation and heart failure remains uneasy. In theory maintenance of sinus rhythm is desirable but the only pharmacological intervention able to do it safely is amiodarone. A trial of strategy randomisation, restoration of sinus rhythm or slowing of atrial fibrillation, has been done in patients with both atrial fibrillation and heart failure. This trial, named AF-CHF has shown neutral results, the 2 strategies, rhythm control or simple rate control were similar in terms of mortality. Dronedarone is an innovative drug bringing new possibilities in the treatment of atrial fibrillation but it is contra-indicated in case of severe heart failure. Another possible approach is that of non pharmacological techniques. Sinus rhythm maintenance may be obtained by pulmonary vein isolation. The other possibility is the ablation of atrio-ventricular node with implantation of a pacemaker, technique which is reserved to selected patients.
authors: Service de Cardiologie A et Rythmologie, Hôpital Européen Georges Pompidou, Université Paris 5, Paris, France. jean-yves.le-heuzey@egp.aphp.fr
authors: Jean-Yves
authors: JY
authors: Le Heuzey
authors: Eloi
authors: E
authors: Marijon
authors: Akli
authors: A
authors: Otmani
authors: Antoine
authors: A
authors: Lepillier
authors: Xavier
authors: X
authors: Waintraub
authors: Thomas
authors: T
authors: Lavergne
authors: Maurice
authors: M
authors: Pornin
mesh_terms: D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans