Related Experiment Video
Updated: Aug 4, 2025
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
33.5K
Prevalence and Prognostic Implication of Atrial Fibrillation in Heart Failure Subtypes: Systematic Review and
Juan Mundisugih1, Kyle B Franke2, Phillip J Tully3
1Department of Cardiology, Lyell McEwin Hospital, Adelaide, SA, Australia.
Heart, Lung & Circulation
|April 1, 2023
Summary
Atrial fibrillation (AF) and heart failure (HF) are linked, with AF prevalence intermediate in Heart Failure with mildly reduced Ejection Fraction (HFmrEF). Co-existing AF and HF increases mortality across all HF types.
Area of Science:
- Cardiology
- Heart Failure Research
- Atrial Fibrillation Studies
Background:
- Atrial fibrillation (AF) and heart failure (HF) are significant contributors to poor patient outcomes.
- The universal definition of HF now includes Heart Failure with mildly reduced Ejection Fraction (HFmrEF).
- This study investigates the association between AF and various HF subtypes, particularly HFmrEF.
Approach:
- A systematic review and meta-analysis of studies published up to July 2022 was conducted.
- Included studies classified HF based on ejection fraction: HFpEF (EF≥50%), HFmrEF (EF 40%-49%), and HFrEF (EF <40%).
- Data from 50 eligible studies encompassing 126,720 acute and 109,683 chronic HF patients were analyzed.
Key Points:
- HFmrEF constituted 10% of acute and 12% of chronic HF patients.
- AF prevalence in acute HF was 38% for HFmrEF, 43% for HFpEF, and 32% for HFrEF.
- Meta-regression indicated shared determinants for AF prevalence across HF subtypes, including age.
- AF was associated with increased all-cause mortality in HFmrEF (HR 1.28), HFpEF (HR 1.14), and HFrEF (HR 1.11) compared to sinus rhythm.
Conclusions:
- The prevalence of AF in HFmrEF is intermediate between HFpEF and HFrEF.
- AF and HF co-exist, sharing determinants across HF classifications.
- The presence of AF alongside any HF subtype is a predictor of increased all-cause mortality.
More Related Videos
Related Concept Videos
01:17Pathophysiology of Heart Failure
1.7K
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...
1.7K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
23
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
23
01:29Heart Failure II: Pathophysiology
19
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...
19
01:27Heart Failure I: Introduction
28
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...
28
01:22Heart Failure Drugs: β-Blockers
406
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
406
01:30Heart Failure V: Medical Management
18
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
18