Atrial fibrillation in congestive heart failure

Seiler, Jens; Stevenson, William G (2010). Atrial fibrillation in congestive heart failure. Cardiology in review, 18(1), pp. 38-50. Baltimore, Md.: Williams & Wilkins 10.1097/CRD.0b013e3181c21cff

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Atrial fibrillation (AF) and heart failure (HF) are common and interrelated conditions, each promoting the other, and both associated with increased mortality. HF leads to structural and electrical atrial remodeling, thus creating the basis for the development and perpetuation of AF; and AF may lead to hemodynamic deterioration and the development of tachycardia-mediated cardiomyopathy. Stroke prevention by antithrombotic therapy is crucial in patients with AF and HF. Of the 2 principal therapeutic strategies to treat AF, rate control and rhythm control, neither has been shown to be superior to the other in terms of survival, despite better survival in patients with sinus rhythm compared with those in AF. Antiarrhythmic drug toxicity and poor efficacy are concerns. Catheter ablation of AF can establish sinus rhythm without the risks of antiarrhythmic drug therapy, but has important procedural risks, and data from randomized trials showing a survival benefit of this treatment strategy are still lacking. In intractable cases, ablation of the atrioventricular junction and placement of a permanent pacemaker is a treatment alternative; and biventricular pacing may prevent or reduce the negative consequences of chronic right ventricular pacing.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Seiler, Jens

ISSN:

1061-5377

Publisher:

Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:10

Last Modified:

17 Mar 2015 19:11

Publisher DOI:

10.1097/CRD.0b013e3181c21cff

PubMed ID:

20010337

Web of Science ID:

000272881600005

URI:

https://boris.unibe.ch/id/eprint/1612 (FactScience: 203390)

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