Atrial Fibrillation (AF) and Heart Failure With Preserved Ejection Fraction (HFpEF): Advances and Challenges

Area of Science:

• Cardiovascular Medicine
• Electrophysiology
• Heart Failure Research

Background:

• Atrial fibrillation and heart failure with preserved ejection fraction represent significant and growing cardiovascular epidemics.
• These two conditions frequently coexist and share complex pathophysiological links.
• Recent advancements necessitate an integrated understanding of their epidemiology, mechanisms, and clinical management.

Purpose of the Study:

• To provide a state-of-the-art review on the confluence of atrial fibrillation and heart failure with preserved ejection fraction.
• To integrate recent advances in electrophysiology and heart failure physiology relevant to these conditions.
• To outline current knowledge and future directions in managing this complex patient population.

Main Methods:

• Comprehensive literature review based on the Philippe Coumel Lecture 2024.
• Integration of data from experimental and clinical studies.
• Analysis of epidemiological features, pathophysiology, and therapeutic strategies.

Main Results:

• The review highlights unique epidemiologic features and pathophysiological mechanisms linking atrial fibrillation and heart failure with preserved ejection fraction.
• It details clinical presentations, prognostic implications, and current therapeutic options, including pharmacologic and non-pharmacologic interventions.
• Significant advances in understanding and managing these intertwined conditions are presented.

Conclusions:

• The convergence of atrial fibrillation and heart failure with preserved ejection fraction presents unique challenges and opportunities in cardiovascular medicine.
• Integrated knowledge of electrophysiology and heart failure physiology is crucial for effective patient care.
• Continued research and evolving therapeutic strategies are essential in this rapidly advancing field.