Systematic review of the management of atrial fibrillation in patients with heart failure

Khand, Aleem; Rankin, Andrew C.; Kaye, G.; Cleland, John G.F.

doi:10.1053/euhj.1999.1767

Cited by 125 publications

(80 citation statements)

References 101 publications

(182 reference statements)

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“…This is consistent with the prevalence of heart failure amongst patients with AF reported by some [1,21]. Other studies suggest a lower prevalence of heart failure [14].…”

Section: Discussionsupporting

confidence: 89%

“…These data were verified from source documents by Clinical Research Associates during the course of the study. However, heart failure is a frequently overlooked condition that is commonly treated with loop diuretics without adequate investigation leading to diagnosis [1,13]. As patients with major renal dysfunction were excluded from this study, it is likely that loop diuretics were being used predominantly to control symptoms and/or signs of heart failure.…”

Section: Methodsmentioning

confidence: 99%

“…Many patients with atrial fibrillation (AF) have major structural heart disease [1]. Many other patients with AF are prescribed loop diuretics, presumably for symptoms or signs of fluid congestion, without investigation for objective evidence of structural heart disease or a diagnosis of heart failure being made.…”

Section: Introductionmentioning

confidence: 99%

“…Many of these patients, if investigated, will have preserved left ventricular systolic function and left atrial dilatation but do not fulfil conventional Doppler criteria for diastolic heart failure [2,3]. Conversely, about 30% of patients with heart failure will be in AF [1] and, for some, AF will be the only obvious cause [4].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of markers of heart failure in patients with atrial fibrillation and the effects of ximelagatran compared to warfarin on the incidence of morbid and fatal events: A report from the SPORTIF III and V trials

Cleland

Shelton

Nikitin

et al. 2007

European J of Heart Fail

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Background: Patients with atrial fibrillation (AF) who also have heart failure have a worse outcome but the diagnosis of heart failure is often missed. Aim: To compare the effects of warfarin and ximelagatran on morbidity and mortality in patients with AF with and without markers of heart failure. Methods and results: Data for 7329 patients from two randomised controlled trials were merged. Treatment with loop diuretics or the presence of left ventricular dysfunction, were used as markers of possible heart failure. The 3555 (49%) patients with markers of heart failure had higher composite event rates on warfarin (10.81% per year [py] [95% CI 9.59 to 12.13]) compared to the 3774 (51%) patients without markers of heart failure (4.18% py [95% CI 3.44 to 5.01]). The composite event rate was lower on ximelagatran overall (6.18% py [95% CI 5.51 to 6.89] versus 7.34% py [95% CI 6.63 to 8.10] on warfarin; P = 0.0219 for the difference) with similar effects in each trial and in patients with and without markers of heart failure, mainly due to fewer heart-failure events (hazard ratio 0.69 [95% CI 0.54 to 0.87]; P b 0.001). Conclusions: Patients with markers of heart failure, even if the diagnosis is not well established, are at increased risk of thromboembolic events and might be targeted for more effective antithrombotic therapy. This might include patients in sinus rhythm as well as AF.

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“…This is consistent with the prevalence of heart failure amongst patients with AF reported by some [1,21]. Other studies suggest a lower prevalence of heart failure [14].…”

Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of markers of heart failure in patients with atrial fibrillation and the effects of ximelagatran compared to warfarin on the incidence of morbid and fatal events: A report from the SPORTIF III and V trials

Cleland

Shelton

Nikitin

et al. 2007

European J of Heart Fail

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show abstract

“…Intravenous amiodarone may be more effective at rate control of AF or atrial flutter and may restore sinus rhythm. In HF patients, amiodarone either alone or with electrical cardioversion is effective at slowing the heart rate and achieving cardioversion (763,764).…”

Section: Heart Failurementioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Zipes¹,

Camm²,

Borggrefe³

et al. 2006

Circulation

1,198

671

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Pharmacological cardioversion for atrial fibrillation/flutter

Cordina

Mead

2002

The Cochrane Database of Systematic Reviews (Protocol)

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Systematic review of the management of atrial fibrillation in patients with heart failure

Abstract: There is a paucity of controlled clinical trial data for the management of AF among patients with heart failure. The interaction between AF and heart failure means that neither can be treated optimally without treating both. Presently treatment should be on a case by case basis.

Cited by 125 publications

References 101 publications

Prevalence of markers of heart failure in patients with atrial fibrillation and the effects of ximelagatran compared to warfarin on the incidence of morbid and fatal events: A report from the SPORTIF III and V trials

Prevalence of markers of heart failure in patients with atrial fibrillation and the effects of ximelagatran compared to warfarin on the incidence of morbid and fatal events: A report from the SPORTIF III and V trials

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Pharmacological cardioversion for atrial fibrillation/flutter

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