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Review
. 2022 Jul;27(4):1201-1210.
doi: 10.1007/s10741-021-10133-6. Epub 2021 Jul 4.

Heart failure and atrial fibrillation: new concepts in pathophysiology, management, and future directions

Grigorios Tsigkas  1 , Anastasios Apostolos  2 , Stefanos Despotopoulos  2 , Georgios Vasilagkos  2 , Eleftherios Kallergis  3 , Georgios Leventopoulos  2 , Virginia Mplani  2 , Periklis Davlouros  2
Affiliations
Review

Heart failure and atrial fibrillation: new concepts in pathophysiology, management, and future directions

Grigorios Tsigkas et al. Heart Fail Rev. 2022 Jul.

Abstract

A bidirectional pathophysiological link connects heart failure and atrial fibrillation, creating a frequent and challenging comorbidity, which includes neurohormonal hyperactivation, fibrosis development, and electrophysiologic remodeling, while they share mutual risk factors. Management for these devastating comorbidities includes most of the established treatment measures for heart failure as well as rhythm or rate control and anticoagulation mostly for atrial fibrillation, which can be achieved with either pharmaceutical or non-pharmaceutical approaches. The current manuscript aims to review the existing literature regarding the underlying pathophysiology, to present the novel trends of treatment, and to predict the future perspective of these two linked diseases with the numerous unanswered questions.

Keywords: Anticoagulation; Atrial fibrillation; Heart failure; Rate control; Rhythm control; Treatment.

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References

    1. Stafylas P, Farmakis D, Kourlaba G et al (2017) The heart failure pandemic: the clinical and economic burden in Greece. Int J Cardiol 227:923–929. https://doi.org/10.1016/j.ijcard.2016.10.042 - DOI - PubMed
    1. Cha YM, Redfield MM, Shen WK, Gersh BJ (2004) Atrial fibrillation and ventricular dysfunction: a vicious electromechanical cycle. Circulation 109:2839–2843. https://doi.org/10.1161/01.CIR.0000132470.78896.A8 - DOI - PubMed
    1. Maisel WH, Stevenson LW (2003) Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol 91:2D-8D. https://doi.org/10.1016/s0002-9149(02)03373-8 - DOI - PubMed
    1. Swedberg K, Olsson LG, Charlesworth A et al (2005) Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with beta-blockers: results from COMET. Eur Heart J 26:1303–1308. https://doi.org/10.1093/eurheartj/ehi166 - DOI - PubMed
    1. Olsson LG, Swedberg K, Ducharme A et al (2006) Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: results from the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) program. J Am Coll Cardiol 47:1997–2004. https://doi.org/10.1016/j.jacc.2006.01.060 - DOI - PubMed

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