Atrial fibrillation and congestive heart failure: A two-way street
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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.
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References and Recommended Reading
- 4.Dries DL, Exner DV, Gersh BJ, et al.: Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. Studies of Left Ventricular Dysfunction. J Am Coll Cardiol 1998, 32:695–703.PubMedCrossRefGoogle Scholar
- 19.Deedwania PC, Singh BN, Ellenbogen K, et al.: Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHFSTAT). The Department of Veterans Affairs CHFSTAT Investigators. Circulation 1998, 98:2574–2579.PubMedGoogle Scholar
- 23.Khan MN, Jais P, Cummings JE, et al.: Randomized controlled trial of pulmonary vein antrum isolation vs AV node ablation with biventricular pacing for treatment of atrial fibrillation in patients with congestive heart failure (PABACHF) [abstract 1929]. Circulation 2005, 112(Suppl II):II-394.Google Scholar