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Is Maintenance of Sinus Rhythm of Value in Patients with Atrial Fibrillation and Heart Failure?

  • Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
  • Published:
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Abstract

Purpose of Review

Heart failure (HF) and atrial fibrillation (AF) frequently co-exist, with the prevalence of AF increasing in patients with more advanced HF symptoms. When present, AF increases morbidity and mortality in patients with HF. The purpose of this review is to examine emerging evidence addressing the value of restoration and maintenance of sinus rhythm in patients with HF.

Recent Findings

Earlier trials comparing a rhythm control strategy with antiarrhythmic drugs have failed to demonstrate benefit in patients with HF and reduced ejection fraction. More recent trials, including the recently published RAFT-AF, utilizing catheter ablation for rhythm control, have shown greater promise, possibly due to reduced medication-related side effects and higher efficacy in maintaining sinus rhythm.

Summary

A strategy of sinus rhythm maintenance with catheter ablation appears to improve mortality, reduce HF events and improve quality of life in patients with AF and HF.

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Funding

Dr. Tang reports grants from the Canadian Institutes of Health Research.

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Authors and Affiliations

  1. Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada

    Mouhannad M. Sadek

  2. Schulich School of Medicine and Dentistry, Western University, University Hospital, 339 Windermere Road, London, ON, C6-116, Canada

    Allan Skanes & Anthony S. L. Tang

Authors
  1. Mouhannad M. Sadek
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  2. Allan Skanes
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Correspondence to Anthony S. L. Tang.

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This article is part of the Topical Collection on Invasive Electrophysiology and Pacing

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Sadek, M.M., Skanes, A. & Tang, A.S.L. Is Maintenance of Sinus Rhythm of Value in Patients with Atrial Fibrillation and Heart Failure?. Curr Cardiol Rep 24, 1227–1231 (2022). https://doi.org/10.1007/s11886-022-01743-z

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  • DOI: https://doi.org/10.1007/s11886-022-01743-z

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