From the Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA.
Crit Pathw Cardiol. 2021 Jun 1;20(2):93-99. doi: 10.1097/HPC.0000000000000235.
Atrial fibrillation (AF) and heart failure (HF) are the 2 emerging epidemics in global cardiovascular disease. AF remains the most common cardiac arrhythmia, affecting over 33 million adults worldwide, and continues to increase in prevalence as the populations of many nations age. The prevalence of HF also surges, now afflicting 37 million adults globally. Interestingly, these 2 disease processes share many of the same risk factors and stem from many of the same pathophysiologic derangements, with AF occurring in over half of all patients with HF and HF occurring in over one third of all patients with AF. Furthermore, exacerbation of one of these ailments often drives decompensation or compromises therapy of the other, and it has been widely reported that coexistence of AF in patients with HF portends a poorer prognosis. As a result, many clinicians now routinely face the problem of AF in the patient with HF. In this review, we highlight the fundamental pathologic forces embedded in the relationship between AF and HF and then proceed to a discussion on the management of these complex patients with a detailed exploration of the clinical data.
心房颤动（AF）和心力衰竭（HF）是全球心血管疾病中的 2 种新兴流行病。AF 仍然是最常见的心律失常，影响全球超过 3300 万成年人，随着许多国家人口老龄化，其患病率继续上升。HF 的患病率也急剧上升，现在影响着全球 3700 万成年人。有趣的是，这两种疾病过程有许多共同的危险因素，并且源于许多相同的病理生理紊乱，超过一半的 HF 患者发生 AF，超过三分之一的 AF 患者发生 HF。此外，一种疾病的恶化常常导致另一种疾病的失代偿或治疗失败，并且广泛报道 HF 患者中存在 AF 预示着预后较差。因此，许多临床医生现在在 HF 患者中经常面临 AF 的问题。在这篇综述中，我们强调了 AF 和 HF 之间关系中嵌入的基本病理力，然后继续讨论这些复杂患者的管理，并详细探讨临床数据。
