Heart Failure and Atrial Fibrillation, Like Fire and Fury

Carlisle, Matthew A.; Fudim, Marat; DeVore, Adam D.; Piccini, Jonathan P.

doi:10.1016/j.jchf.2019.03.005

Cited by 218 publications

(190 citation statements)

References 36 publications

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“…Atrial fibrillation (AF) is an additional factor contributing to the mobility across the LVEF categories. AF can worsen pre‐existing LV dysfunction or underlying cardiomyopathy, with a partial or complete improvement of the LVEF after the restoration of sinus rhythm . A substantial number of patients may move in and out of HFmrEF group on serial echocardiograms, without any change of underlying pathology ( Figure ) …”

Section: Left Ventricular Ejection Fraction Based Classification: Oppmentioning

confidence: 99%

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

et al. 2020

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Currently, the assessment of left ventricular ejection fraction (LVEF) is the cornerstone of the classification of patients with heart failure (HF). The mid-range LVEF (HFmrEF) category was identified in an attempt to uncover specific characteristics of these patients. So far, the analysis of trials, registries, and observational studies have demonstrated that patients with midrange LVEF belong to a patient cohort with generally intermediate clinical profile as compared with other groups but with a remarkable variety of intrinsic phenotypes. This is due to the limitations of LVEF as the sole criterion to categorize patients with HF and characterize their prognosis, above all when it is >40%. To better define the HFmrEF phenotype, it is reasonable to consider other parameters, such as LVEF changes over time, HF aetiology, co-morbidities, and other imaging parameters. A multiparametric evaluation may contextualize a patient with HFmrEF in a more defined phenotype with a specific prognosis.

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Section: Left Ventricular Ejection Fraction Based Classification: Oppmentioning

confidence: 99%

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

et al. 2020

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“…Furthermore, AF promotes different levels of vessel wall damage [15]. Regarding AF and heart failure, it has been suggested that they are different expressions of the same underlying systemic disease, where inflammation is significantly involved in both conditions and in many of their shared comorbidities [16][17][18][19]. In short, in the context of primary AF there are several identified mechanisms regarding associations with outcome.…”

Section: Introductionmentioning

confidence: 99%

Compared with matched controls, patients with postoperative atrial fibrillation (POAF) have increased long-term AF after CABG, and POAF is further associated with increased ischemic stroke, heart failure and mortality even after adjustment for AF

et al. 2020

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Objective To analyze (1) associations between postoperative atrial fibrillation (POAF) after CABG and long-term cardiovascular outcome, (2) whether associations were influenced by AF during follow-up, and (3) if morbidities associated with POAF contribute to mortality. Methods An observational cohort study of 7145 in-hospital survivors after isolated CABG (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012), with preoperative sinus rhythm and without AF history. Incidence of AF was compared with matched controls. Time-updated covariates were used to adjust for POAF-related morbidities during follow-up, including AF. Results Thirty-one percent of patients developed POAF. Median follow-up was 9.8 years. POAF patients had increased AF compared with matched controls (HR 3.03; 95% CI 2.66-3.49), while AF occurrence in non-POAF patients was similar to controls (1.00; 0.89-1.13). The observed AF increase among POAF patients compared with controls persisted over time (> 10 years 2.73; 2.13-3.51). Conversely, the non-POAF cohort showed no AF increase beyond the first postoperative year. Further, POAF was associated with long-term AF (adjusted HR 3.20; 95% CI 2.

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“…Moreover, HF has also been shown to cause interstitial fibrosis and remodeling of the LA, and this can serve as a substrate to propagate AF thereby setting up a vicious cycle of worsening HF. 15 AADs have a limited role to play in HF due to potential toxicities, and this led to interest in the potential role of CA to restore sinus rhythm in these patients. Early studies have shown us that CA can cause improvement in the left ventricular ejection fraction (LVEF) ($5-10%) from baseline, decrease brain natriuretic peptide levels and HF hospitalizations and improve both QOL and functional capacity in the form of increase in peak oxygen consumption and 6-minute walk distances, an important prognostic indicator.…”

Section: Role Of Catheter Ablation In Patients With Heart Failurementioning

confidence: 99%

Is Catheter Ablation Better Than Antiarrhythmic Drugs for the Treatment of Atrial Fibrillation?

2020

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Long-standing atrial fibrillation is associated with significant morbidity including stroke and development of heart failure. Patients also report poor quality of life as a result of debilitating symptoms or treatment side effects from antiarrhythmic medications. Radio frequency or cryothermal mediated catheter ablation has a central role in the management of symptomatic patients with paroxysmal or persistent atrial fibrillation. Circumferential pulmonary vein isolation is vital to the success of this therapy and other ancillary techniques have been described, especially for persistent atrial fibrillation. Several randomized controlled studies have been reported over the last two decades studying important clinical outcomes in patients with atrial fibrillation. In this article, we aim to provide a review of the major studies that have helped define the role of catheter ablation in the management of symptomatic atrial fibrillation in patients with both diseased and structurally normal hearts.

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Heart Failure and Atrial Fibrillation, Like Fire and Fury

Cited by 218 publications

References 36 publications

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

Heart failure with mid‐range ejection fraction: pro and cons of the new classification of Heart Failure by European Society of Cardiology guidelines

Compared with matched controls, patients with postoperative atrial fibrillation (POAF) have increased long-term AF after CABG, and POAF is further associated with increased ischemic stroke, heart failure and mortality even after adjustment for AF

Is Catheter Ablation Better Than Antiarrhythmic Drugs for the Treatment of Atrial Fibrillation?

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