[Atrial fibrillation and heart failure: a dangerous criminal conspiracy]

Area of Science:

• Cardiology
• Internal Medicine

Context:

• Atrial fibrillation (AF) and heart failure (HF) commonly coexist in patients.
• This dual diagnosis is linked to significantly higher mortality rates.
• The interplay between AF and HF involves shared risk factors and a direct causative relationship.

Purpose:

• To explore the intricate relationship between atrial fibrillation and heart failure.
• To investigate the mechanisms by which AF can cause HF, including tachycardia-induced cardiomyopathy.
• To examine HF as a cause of AF and discuss the ongoing debate on AF's independent mortality risk in HF.

Summary:

• AF can precipitate HF, particularly through tachycardia-induced cardiomyopathy, either independently or alongside existing heart conditions.
• Conversely, HF is a recognized cause of AF.
• The precise role of AF as an independent mortality factor versus a marker of advanced HF requires further investigation, potentially due to limitations in current therapeutic interventions.

Impact:

• Highlights the critical need for integrated management strategies for patients with both AF and HF.
• Emphasizes the importance of understanding the causative links to guide therapeutic development.
• Suggests that improved treatments for AF may be essential for reducing mortality in HF patients.