Related Experiment Video

Updated: May 12, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Atrial fibrillation and heart failure: beyond the heart rate

Anuj Garg1, Nazem Akoum

  • 1University of Utah Division of Cardiology, Section of Cardiac Electrophysiology, Utah, USA.

Current Opinion in Cardiology
|April 4, 2013
PubMed

Insights

Catheter ablation for atrial fibrillation may improve outcomes in heart failure patients, offering a personalized approach beyond simple rate control for this common cardiovascular condition.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Imaging

Background:

  • Atrial fibrillation and heart failure frequently coexist, significantly increasing patient morbidity and mortality.
  • Effective management strategies for this dual cardiovascular epidemic are under continuous investigation.

Purpose of the Study:

  • To review current management strategies for patients with coexisting atrial fibrillation and heart failure.
  • To evaluate the efficacy and safety of different treatment approaches, including rhythm control versus rate control.

Main Methods:

  • Analysis of recent clinical trials comparing rhythm control and rate control strategies for atrial fibrillation in heart failure patients.
  • Evaluation of catheter ablation as a rhythm control method, including patient selection using late-gadolinium-enhancement cardiac MRI (LGE-MRI) for atrial fibrosis assessment.
  • Consideration of alternative strategies like AV nodal ablation with bi-ventricular pacing.

Main Results:

  • Rhythm control for atrial fibrillation using antiarrhythmic drugs did not show a survival advantage over rate control in heart failure with reduced ejection fraction, and some agents increased mortality.
  • Catheter ablation demonstrates promising efficacy in maintaining sinus rhythm for atrial fibrillation patients, particularly those with heart failure.
  • LGE-MRI can identify suitable candidates for atrial fibrillation ablation.
  • Rhythm control may be beneficial for atrial fibrillation patients with heart failure and preserved ejection fraction.

Conclusions:

  • Patients with atrial fibrillation and heart failure represent a heterogeneous group requiring individualized treatment plans.
  • Catheter ablation to restore and maintain sinus rhythm is a promising therapeutic option that may offer advantages over mere rate control.
Abstract

More Related Videos

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation09:17

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation

Published on: July 29, 2011

Related Concept Videos

Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...