Atrial arrhythmias and heart failure: A “modern view” of an old paradox

Abstract

Background: Heart failure (HF) and atrial arrhythmias (AAs) are two clinical conditions that characterize the daily clinical practice of cardiologists. In this perspective review, we analyze the shared etiopathogenetic pathways of atrial arrhythmias, which are the most common cause of atrial arrhythmias-induced cardiomyopathy (AACM) and HF. Hypothesis:The aim is to explore the pathophysiology of these two conditions considering them as a "unicum", allowing the definition of a cardiovascular continuum where it is possible to predict the factors and to identify the patient phenotype most at risk to develop HF due to atrial arrhythmias.Methods: Potentially eligible articles, identified from the Electronic database (PubMed), and related references were used for a literature search that was conducted between January 2022 and January 2023. Search strategies were designed to identify articles that reported atrial arrhythmias in association with heart failure and vice versa. For the search we used the following keywords: atrial arrhythmias, atrial fibrillation, heart failure, arrhythmia-induced cardiomyopathy, tachycardiomyopathy. We identified 620 articles through the electronic database search. Out of the 620 total articles we removed 320 duplicates, thus selecting 300 eligible articles.

Effect of SGLT2 inhibitors on cardiovascular events in patients with atrial fibrillation: A systematic review and meta‐analysis of randomized controlled trials

“…[1][2][3] Moreover, multiple metabolic and cardiovascular (CV) risk factors, like blood pressure, obesity, and blood glucose, underlying the pathogenesis of AF and HF, are also important to the prognosis and management of AF and HF. 4,5 However, there is still a large gap of evidence on the benefit of disease-modifying drugs for HF and CV diseases, such as β-blockers and statin, in AF population. 6 Recently, sodium-glucose co-transporter-2 inhibitors (SGLT2i), a novel oral hypoglycemic drug, have been proven to reduce the risk of HF hospitalization and CV death in patients with diabetes or HF in addition to its own hypoglycemic effects.…”