Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada.
Schulich School of Medicine and Dentistry, Western University, University Hospital, 339 Windermere Road, London, ON, C6-116, Canada.
Curr Cardiol Rep. 2022 Oct;24(10):1227-1231. doi: 10.1007/s11886-022-01743-z. Epub 2022 Jul 23.
Heart failure (HF) and atrial fibrillation (AF) frequently co-exist, with the prevalence of AF increasing in patients with more advanced HF symptoms. When present, AF increases morbidity and mortality in patients with HF. The purpose of this review is to examine emerging evidence addressing the value of restoration and maintenance of sinus rhythm in patients with HF.
Earlier trials comparing a rhythm control strategy with antiarrhythmic drugs have failed to demonstrate benefit in patients with HF and reduced ejection fraction. More recent trials, including the recently published RAFT-AF, utilizing catheter ablation for rhythm control, have shown greater promise, possibly due to reduced medication-related side effects and higher efficacy in maintaining sinus rhythm. A strategy of sinus rhythm maintenance with catheter ablation appears to improve mortality, reduce HF events and improve quality of life in patients with AF and HF.
心力衰竭（HF）和心房颤动（AF）常同时存在，随着 HF 症状加重，AF 的患病率也会增加。当存在 AF 时，HF 患者的发病率和死亡率会增加。本综述的目的是探讨新出现的证据，评估恢复和维持 HF 患者窦性心律的价值。
先前比较节律控制策略与抗心律失常药物的试验未能证明对射血分数降低的 HF 患者有益。最近的试验，包括最近发表的 RAFT-AF，使用导管消融进行节律控制，显示出更大的希望，这可能是由于减少了药物相关的副作用和维持窦性心律的更高疗效。采用导管消融维持窦性心律的策略似乎可以改善死亡率、减少 HF 事件并改善 AF 和 HF 患者的生活质量。
