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Pathophysiology of Atrial Fibrillation and Heart Failure: Dangerous Interactions

Hariharan Sugumar1, Shane Nanayakkara2, Sandeep Prabhu1

  • 1Department of clinical research, The Baker Heart and Diabetes Institute, 75 Commercial road, Melbourne, Victoria, 3004 Australia; Department of Cardiology, The Alfred Hospital, 55 Commercial road, Melbourne, Victoria, 3004, Australia; Department of Cardiology, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia; Department of Medicine, University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia.

Cardiology Clinics
|March 31, 2019
PubMed

Insights

Atrial fibrillation and heart failure (HF) frequently coexist, worsening patient outcomes. This review explores the complex pathophysiologic interactions between atrial fibrillation and both HF with reduced ejection fraction and HF with preserved ejection fraction.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pathophysiology

Background:

  • Atrial fibrillation (AF) and heart failure (HF) are common comorbidities.
  • Their coexistence significantly increases morbidity and mortality.
  • Shared risk factors contribute to their mutual exacerbation.

Purpose of the Study:

  • To review the pathophysiologic relationship between AF and HF.
  • To elucidate the interactions in HF with reduced ejection fraction (HFrEF).
  • To examine the interactions in HF with preserved ejection fraction (HFpEF).

Main Methods:

  • Literature review of pathophysiologic mechanisms.
  • Analysis of studies on AF-HF interactions.
  • Synthesis of current understanding of AF's impact on HFrEF and HFpEF.

Main Results:

  • AF and HF share common risk factors.
  • AF exacerbates both HFrEF and HFpEF through distinct mechanisms.
  • Understanding these interactions is crucial for management.

Conclusions:

  • The interplay between AF and HF is complex and bidirectional.
  • Targeting AF may improve outcomes in HF patients.
  • Further research is needed to optimize therapeutic strategies.

Keywords:
Atrial fibrillationCardiomyopathyDiastolic dysfunctionHFpEFHFrEFHeart failurePathophysiologyTachycardiomyopathy

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