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Atrial Fibrillation and Heart Failure - Cause or Effect?
Sandeep Prabhu1, Aleksandr Voskoboinik1, David M Kaye2
1The Alfred Hospital, Melbourne, Vic, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; University of Melbourne, Melbourne, Vic, Australia.
Heart, Lung & Circulation
|July 8, 2017
Summary
Atrial fibrillation (AF) and heart failure often coexist due to shared mechanisms. Understanding if AF drives heart failure is crucial for effective treatment, especially with advancements like catheter ablation.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Emerging epidemics of atrial fibrillation (AF) and heart failure present a significant global health burden.
- AF and heart failure frequently coexist (up to 30% of patients) due to shared pathophysiological mechanisms.
- The temporal relationship between AF and heart failure is often unclear, posing diagnostic and therapeutic challenges.
Purpose of the Study:
- To review the inter-related physiological drivers of AF and heart failure.
- To explore whether AF contributes to left ventricular (LV) dysfunction, rather than being solely a consequence of heart failure.
- To consider the implications of recent clinical trial outcomes for patients with coexisting AF and heart failure.
Main Methods:
- Literature review of shared pathophysiological mechanisms between AF and heart failure.
- Analysis of clinical trial data examining the impact of AF on LV function.
- Discussion of advancements in catheter ablation as a treatment strategy.
Main Results:
- Shared pathophysiological pathways contribute to the frequent co-occurrence of AF and heart failure.
- Evidence suggests AF can be a significant driver of LV dysfunction.
- Catheter ablation shows promise as an advanced therapeutic option.
Conclusions:
- The interplay between AF and heart failure is complex, with AF potentially driving cardiac dysfunction.
- Clarifying the causal relationship is essential for optimizing patient management.
- Emerging treatments like catheter ablation offer new avenues for improving outcomes in these patients.
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