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Atrial fibrillation and heart failure: is atrial fibrillation a disease?

V Tilman1

  • 1The Sheba Medical Center, Rehabilitation Hospital, Ramat Gan, Israel.

Medical Hypotheses
|June 28, 2014
PubMed

Insights

Atrial fibrillation may protect against pulmonary edema in heart failure by stopping left atrial contraction. This reduces dangerous pressure buildup in the lungs, explaining their common co-occurrence.

Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Physiology

Background:

  • Heart failure (HF) is frequently associated with atrial fibrillation (AF).
  • The underlying mechanisms linking HF and AF require further investigation.
  • Increased end-diastolic pressure in HF can lead to pulmonary edema via pressure transmission.

Purpose of the Study:

  • To explore the hypothesis that atrial fibrillation may serve a protective role in heart failure.
  • To investigate the potential of AF in mitigating elevated pulmonary pressures associated with HF.

Main Methods:

  • The study reviews the physiological impact of left atrial mechanical systole on circulatory pressures.
  • It analyzes how atrial fibrillation disrupts left atrial systole and subsequent pressure transmission.
  • The relationship between end-diastolic pressure, pulmonary wedge pressure, and pulmonary edema is examined.

Main Results:

  • Left atrial systole contributes to increased end-diastolic pressure in heart failure.
  • Atrial fibrillation eliminates left atrial mechanical systole.
  • This cessation of systole reduces intercommunicating system pressure and pulmonary wedge pressure.

Conclusions:

  • Atrial fibrillation may act as a compensatory mechanism in heart failure.
  • By reducing pulmonary wedge pressure, AF could prevent pulmonary edema.
  • This provides a potential explanation for the frequent co-occurrence of heart failure and atrial fibrillation.

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