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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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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...
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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...
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Heart Failure I: Introduction01:27

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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...
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Heart Failure VI: Adjunct Therapies01:22

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Amyloid Fibrils03:03

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Amyloid fibrils are aggregates of misfolded proteins.  Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils. 
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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Related Experiment Video

Updated: Feb 15, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation for Atrial Fibrillation with Heart Failure.

Nassir F Marrouche1, Johannes Brachmann1, Dietrich Andresen1

  • 1From the Comprehensive Arrhythmia Research and Management Center, Division of Cardiovascular Medicine, School of Medicine, University of Utah Health, Salt Lake City (N.F.M.); Klinikum Coburg, Coburg (J.B.), Kardiologie an den Ev. Elisabeth-Kliniken (D.A.) and Biotronik (J.P., H.S.), Berlin, Klinik Rotes Kreuz, Frankfurt/Main (J.S.), Klinikum Links der Weser, Bremen (L.B.), Deutsches Herzzentrum München, Munich (H.C.), Institute of Medical Statistics and Computational Biology, Cologne (D.B.), and KMG Klinikum, Güstrow (J.V.) - all in Germany; Antonius Ziekenhuis Nieuwegein, Nieuwegein (L.J.), and the Erasmus University Medical Center, Rotterdam (B.M.) - both in the Netherlands; Semmelweis Medical University, Budapest, Hungary (E.P.); and the State Research Institute of Circulation Pathology, Novosibirsk, Russia (P.S.).

The New England Journal of Medicine
|February 1, 2018
PubMed
Summary

Catheter ablation significantly reduced death and heart failure hospitalizations in patients with atrial fibrillation and heart failure compared to medical therapy. This procedure offers improved outcomes for this high-risk patient group.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Patients with atrial fibrillation (AF) and heart failure (HF) experience higher mortality and morbidity.
  • Catheter ablation is a potential intervention to improve outcomes in this population.

Purpose of the Study:

  • To evaluate the efficacy of catheter ablation versus medical therapy for AF in patients with HF.

Main Methods:

  • A randomized trial assigned 363 patients with symptomatic AF and HF (LVEF ≤35%) to catheter ablation or medical therapy.
  • The primary endpoint was a composite of all-cause death or hospitalization for worsening HF.

Main Results:

  • Catheter ablation significantly reduced the primary composite endpoint (28.5% vs. 44.6%, P=0.007).
  • Ablation also led to significant reductions in all-cause mortality (13.4% vs. 25.0%, P=0.01) and HF hospitalizations (20.7% vs. 35.9%, P=0.004).

Conclusions:

  • Catheter ablation for AF in patients with HF significantly lowers the risk of death and HF hospitalizations.
  • This strategy represents an effective treatment option for improving outcomes in heart failure patients with atrial fibrillation.