Leong-Sit Peter, Tang Anthony S L
Division of Cardiology, Western University, Ontario, Canada.
Curr Opin Cardiol. 2015 Mar;30(2):161-167. doi: 10.1097/HCO.0000000000000144.
Heart failure and atrial fibrillation are both common cardiac conditions that share multiple risk factors. Heart failure is a risk for atrial fibrillation and atrial fibrillation is a risk for heart failure. The need to understand the interplay between these two cardiac conditions and the effectiveness of management options becomes increasingly relevant.
Recent studies have focused on the prognostic nature of atrial fibrillation and heart failure, the questionable utility of digoxin and beta-blocker therapy when heart failure and atrial fibrillation coexist, and the efficacy of cardiac ablation and resynchronization therapy with concomitant heart failure and atrial fibrillation.
The predominant questions that require further attention with respect to atrial fibrillation and heart failure are whether catheter ablation and rhythm control offers benefit in a high-risk heart failure population with respect to mortality or heart failure reduction, and whether cardiac resynchronization therapy implantation truly benefits the subgroup of candidate patients with permanent atrial fibrillation. Large randomized multicentre studies are currently ongoing to address these important questions.
心力衰竭和心房颤动均为常见的心脏疾病，具有多种共同的危险因素。心力衰竭是心房颤动的一个危险因素，而心房颤动也是心力衰竭的一个危险因素。了解这两种心脏疾病之间的相互作用以及管理方案的有效性变得越来越重要。
近期的研究集中在心房颤动和心力衰竭的预后性质、心力衰竭与心房颤动并存时地高辛和β受体阻滞剂治疗的可疑效用，以及心脏消融和心脏再同步治疗在合并心力衰竭和心房颤动时的疗效。
关于心房颤动和心力衰竭，需要进一步关注的主要问题是，导管消融和节律控制对于高危心力衰竭人群在降低死亡率或减少心力衰竭方面是否有益，以及心脏再同步治疗植入对于永久性心房颤动候选患者亚组是否真的有益。目前正在进行大型随机多中心研究以解决这些重要问题。
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