Related Experiment Video

Updated: Feb 13, 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

34.2K

Anticoagulation in heart failure without atrial fibrillation: gaps and dilemmas in current clinical practice

Roxana-Nicoleta Siliste1, Elena-Laura Antohi2, Sergey Pepoyan3

  • 1Department of Internal Medicine and Cardiology, Coltea Clinical Hospital, Bucharest, Romania.

European Journal of Heart Failure
|March 6, 2018
PubMed

Insights

Heart failure (HF) patients in sinus rhythm face increased thromboembolic risk. However, current evidence does not support routine use of oral anticoagulants (OACs) due to bleeding risks outweighing benefits.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure (HF) is linked to a higher risk of thromboembolic events.
  • Current guidelines do not recommend routine anticoagulation for HF patients in sinus rhythm.

Purpose of the Study:

  • To review existing evidence on anticoagulation therapy in HF patients with sinus rhythm.
  • To identify knowledge gaps for future clinical trial design.

Main Methods:

  • Review of observational studies and post-hoc analyses.
  • Analysis of clinical outcomes, efficacy, and safety data.

Main Results:

  • Observational data suggest increased thromboembolic risk in HF patients.
  • Major bleeding risk with oral anticoagulants (OACs) appears to outweigh benefits in this population.
  • No significant mortality benefit observed with OACs in HF patients in sinus rhythm.

Conclusions:

  • Anticoagulation therapy in HF patients in sinus rhythm is not currently supported by robust clinical trial data.
  • Future research should focus on identifying specific HF patient subgroups who may benefit from anticoagulation.
  • Careful consideration of the benefit-risk profile is crucial for any potential anticoagulation strategy in this population.

Keywords:
AnticoagulationHeart failurePredictive scoresStrokeThromboembolic eventsThrombosis

More Related Videos

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.6K
Robotic Ablation of Atrial Fibrillation11:21

Robotic Ablation of Atrial Fibrillation

Published on: May 29, 2015

20.2K

Related Concept Videos

Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
641
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...
1.0K
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...
4.0K
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...
958
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

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.
399
Amyloid Fibrils03:03

Amyloid Fibrils

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. 
Amyloid deposits were observed as early as 1639 in the liver and the spleen.   In 1854, Rudolph Virchow performed iodine staining,...
12.1K