Evidence Builds for Catheter Ablation for Atrial Fibrillation and Heart Failure

Pokorney, Sean D.; Granger, Christopher B.

doi:10.1161/circulationaha.122.059885

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Ablation procedures aim to restore and maintain normal sinus rhythm by targeting the irregular electrical pathways in the atria responsible for AF. The rationale behind ablation in heart failure lies in its potential to improve left ventricular function, reduce symptoms, and enhance the overall quality of life for affected individuals [ 75 , 76 , 77 , 78 , 79 ]. By eliminating or modifying the abnormal electrical circuits contributing to AF, ablation may mitigate the detrimental effects of AF on cardiac hemodynamics and consequently alleviate heart failure symptoms.…”

Section: Future Therapeutic Perspectives In Hfrefmentioning

confidence: 99%

“…By eliminating or modifying the abnormal electrical circuits contributing to AF, ablation may mitigate the detrimental effects of AF on cardiac hemodynamics and consequently alleviate heart failure symptoms. This therapeutic approach represents a valuable strategy in the multidisciplinary management of patients with concurrent AF and HFrEF, offering a potential avenue for improved clinical outcomes and enhanced quality of life [ 75 , 76 , 77 , 78 , 79 ].…”

Section: Future Therapeutic Perspectives In Hfrefmentioning

confidence: 99%

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Beyond Quadruple Therapy and Current Therapeutic Strategies in Heart Failure with Reduced Ejection Fraction: Medical Therapies with Potential to Become Part of the Therapeutic Armamentarium

Kourek,

Briasoulis,

Papamichail

et al. 2024

IJMS

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Heart failure with reduced ejection fraction (HFrEF) is a complex clinical syndrome with significant morbidity and mortality and seems to be responsible for approximately 50% of heart failure cases and hospitalizations worldwide. First-line treatments of patients with HFrEF, according to the ESC and AHA guidelines, include β-blockers, angiotensin receptor/neprilysin inhibitors, sodium-glucose cotransporter 2 inhibitors, and mineralocorticoid receptor antagonists. This quadruple therapy should be initiated during hospital stay and uptitrated to maximum doses within 6 weeks after discharge according to large multicenter controlled trials. Quadruple therapy improves survival by approximately 8 years for a 55-year-old heart failure patient. Additional therapeutic strategies targeting other signaling pathways such as ivabradine, digoxin, and isosorbide dinitrate and hydralazine combination for African Americans, as well as adjunctive symptomatic therapies, seem to be necessary in the management of HFrEF. Although second-line medications have not achieved improvements in mortality, they seem to decrease heart failure hospitalizations. There are novel medical therapies including vericiguat, omecamtiv mecarbil, genetic and cellular therapies, and mitochondria-targeted therapies. Moreover, mitraclip for significant mitral valve regurgitation, ablation in specific atrial fibrillation cases, omecamtiv mecarbil are options under evaluation in clinical trials. Finally, the HeartMate 3 magnetically levitated centrifugal left ventricular assist device (LVAD) has extended 5-year survival for stage D HF patients who are candidates for an LVAD.

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