University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada.
Center for Cardiovascular Innovation, Vancouver, Canada.
Curr Heart Fail Rep. 2022 Jun;19(3):126-135. doi: 10.1007/s11897-022-00543-4. Epub 2022 Mar 30.
Atrial fibrillation (AF) and heart failure (HF) are commonly encountered clinical disorders that often co-exist, accelerating disease progression and adverse outcomes. It is known that restoration of sinus rhythm positively impacts this population; however, the complex comorbidity profile associated with HF introduces intricacies not encountered in other patient populations. The current review focuses on the safety and efficacy of an interventional-based management for atrial tachyarrhythmias in HF.
While pharmacotherapy has been the standard treatment of cardiac dysrhythmias in the HF population, recent evidence suggests catheter ablation is more effective and causes less harm than antiarrhythmic drugs (AADs) in the HF population. For the maintenance of sinus rhythm, catheter ablation results in improved freedom from recurrent arrhythmia, with secondary benefit on mortality and hospitalization in those with HF and reduced ejection fraction. For those with permanent AF, cardiac resynchronization therapy and atrioventricular junction ablation result in improved quality of life, physical functioning, and cardiac function.
心房颤动（AF）和心力衰竭（HF）是常见的临床疾病，常同时存在，加速疾病进展和不良结局。已知窦性节律的恢复对这类人群有积极影响；然而，HF 相关的复杂合并症特征引入了其他患者群体中未遇到的复杂性。本综述重点关注 HF 患者房性心动过速的介入治疗管理的安全性和有效性。
尽管药物治疗一直是 HF 人群中心律失常的标准治疗方法，但最近的证据表明，导管消融在 HF 人群中的效果优于抗心律失常药物（AADs），且危害更小。对于维持窦性节律，导管消融可提高心律失常复发的无复发生存率，并对 HF 和射血分数降低患者的死亡率和住院率有次要益处。对于永久性 AF 患者，心脏再同步治疗和房室结消融可提高生活质量、身体机能和心脏功能。
