Faculty of Medicine, School of Health Sciences, Universidad Pontificia Bolivariana. Street 1A, No 70-01, Medellín 050031, Colombia.
Faculty of Medicine, School of Health Sciences, Universidad Pontificia Bolivariana. Street 1A, No 70-01, Medellín 050031, Colombia.
Curr Probl Cardiol. 2024 Dec;49(12):102841. doi: 10.1016/j.cpcardiol.2024.102841. Epub 2024 Sep 4.
Heart failure (HF) can coexist with atrial fibrillation in up to 60 % of cases, increasing rates of hospitalizations and death. This study analyzed the clinical characteristics, treatment, hospitalization, and mortality of patients with HF and atrial fibrillation based on left ventricular ejection fraction (LVEF).
A retrospective cohort study included patients from an outpatient HF clinic at Medellín (Colombia) between 2020-2022. Patients were classified into two groups according to LVEF: reduced (LVEF≤40 %) and mildly reduced or preserved ejection fraction (LVEF>40 %). The evaluated outcomes were hospitalization and mortality during follow-up. Values for B-type natriuretic peptide (BNP), LVEF and functional class according to the New York Heart Association (NYHA) were also analyzed at admission and during the last follow-up visit.
The study included 185 patients, with 51.9% being male. The median age of the participants was 80 years (interquartile range [IQR] 74 - 86). There was an overall improvement in the NYHA functional class, BNP levels, and LVEF compared with the baseline values, irrespective of left systolic function. Atrial fibrillation ablation was performed in 3.2 % of patients, and cardiac device implantation with atrioventricular node ablation in 29 %. No statistically significant differences were found in terms of hospitalization and mortality regarding left systolic function.
Compressive optimal treatment for patients with HF and atrial fibrillation requires pharmacological treatment, ablation strategies, cardiac devices, cardiovascular rehabilitation and close follow-up. In this cohort, hospitalization and mortality rates were similar according to LVEF categories and there was improvement in NYHA functional class and BNP level.
心力衰竭（HF）在多达 60%的病例中可与心房颤动共存，增加了住院和死亡的发生率。本研究根据左心室射血分数（LVEF）分析了 HF 和心房颤动患者的临床特征、治疗、住院和死亡率。
一项回顾性队列研究纳入了 2020 年至 2022 年期间在麦德林（哥伦比亚）的一个门诊 HF 诊所的患者。根据 LVEF 将患者分为两组：射血分数降低（LVEF≤40%）和轻度降低或射血分数保留（LVEF>40%）。评估的结果是随访期间的住院和死亡率。入院时和最后一次随访时还分析了 B 型利钠肽（BNP）、LVEF 和根据纽约心脏协会（NYHA）的功能分级的值。
研究纳入了 185 名患者，其中 51.9%为男性。参与者的中位年龄为 80 岁（四分位距 [IQR] 74-86）。无论左心室收缩功能如何，NYHA 功能分级、BNP 水平和 LVEF 均与基线值相比整体改善。3.2%的患者接受了心房颤动消融治疗，29%的患者接受了心脏装置植入和房室结消融治疗。左心室收缩功能方面，住院和死亡率无统计学差异。
HF 和心房颤动患者的综合优化治疗需要药物治疗、消融策略、心脏装置、心血管康复和密切随访。在本队列中，根据 LVEF 类别，住院率和死亡率相似，NYHA 功能分级和 BNP 水平均有所改善。
