title: Atrial fibrillation in heart failure: drug therapies for rate and rhythm control.
abstract: Pharmacological treatment of atrial fibrillation in the context of heart failure poses numerous challenges. Management decisions are limited by contraindications to several drugs and the paucity of robust clinical trials that provide evidence-based guidance. This review proposes a structured action plan for managing atrial fibrillation coexisting with heart failure that considers published clinical guidelines and integrates recent data derived from substudies of randomized trials, including the atrial fibrillation and congestive heart failure (AF-CHF) trial. Areas of uncertainty, such as target heart rates in atrial fibrillation and upstream therapies, are also discussed.
authors.affiliation: Department of Medicine, Montreal Heart Institute, Université de Montréal, 5000 Belanger St. E, Montreal, QC, H1T 1C8, Canada.
authors.forename: Rafik
authors.initials: R
authors.lastname: Tadros
authors.forename: Paul
authors.initials: P
authors.lastname: Khairy
authors.forename: Jean L
authors.initials: JL
authors.lastname: Rouleau
authors.forename: Mario
authors.initials: M
authors.lastname: Talajic
authors.forename: Peter G
authors.initials: PG
authors.lastname: Guerra
authors.forename: Denis
authors.initials: D
authors.lastname: Roy
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000145:classification / Q000494:pharmacology; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000075202:Contraindications; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D054539:Medication Therapy Management; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic
chemical_list: D000889:Anti-Arrhythmia Agents