Mutual relationship between heart failure and atrial fibrillation

Abstract

Atrial fibrillation (AF) and heart failure (HF) are evolving epidemies, together responsible for substantial human suffering and health-care expenditure. The simultaneous co-hexistence of the two conditions is associated with mortality rates higher than those observed in individuals with only one or none of them. Patients with concomitant HF and AF suffer from even worse symptoms and poorer prognosis, yet evidence-based evaluation and management of this group of patients is lacking. In this review, we evaluate the common mechanisms for the development of AF in HF patients and vice versa, focusing on the evidence for potential treatment strategies. Recent data have suggested that these patients may respond differently if compared to those with HF or AF alone. These results highlight the clear clinical need to identify and treat these diseases according to best evidence, in order to prevent adverse outcomes and reduce the huge burden that HF and AF are expected to have on global healthcare systems in the future.

Factors associated with disease progression in patients with atrial fibrillation and heart failure anticoagulated with rivaroxaban

“…In this study, 24% of patients had HF, of whom 41% were ≥75‐year‐old, CHA 2 DS 2 ‐VASc score was 3.9% and 38% had HF with reduced ejection fraction 25 . In summary, patients with HF and AF are usually elderly, with a significant burden of comorbidities, and share etiopathogenic and risk factors 26 . Therefore, our sample was representative of real‐life patients with AF and HF.…”

“… 25 In summary, patients with HF and AF are usually elderly, with a significant burden of comorbidities, and share etiopathogenic and risk factors. 26 Therefore, our sample was representative of real‐life patients with AF and HF. On the other hand, our study provided relevant information of the whole spectrum of HF, regardless of ejection fraction or the etiology of HF, as this study lacked strict selection criteria and may capture the effects of rivaroxaban in the real‐world Spanish setting, supporting the generalizability of the results.…”

Role of Prophylactic Use of Amiodarone to Prevent Post-Operative Dysrhythmias in Patients with Low Ejection Fraction (EF ≤35%)

“…Amiodarone is categorized as a class III agent (Vaughn-Williams classification), which combines anti -beta-adrenergic effects with sodium, potassium, and calcium channel blocking properties 10,11,12 . Amiodarone prolongs the AV nodal refraction and conduction time due to calciumchannel blockade.…”