Tulane Research Innovation for Arrhythmia Discovery (TRIAD), New Orleans, LA, USA.
Curr Heart Fail Rep. 2024 Nov 22;22(1):3. doi: 10.1007/s11897-024-00691-9.
Atrial fibrillation and heart failure frequently co-exist. This review discusses the comorbidity of atrial fibrillation and heart failure, the bi-directional link between them, and the recent advances in the management of these co-existing diseases.
Catheter ablation received a class 1 A recommendation for patients with AF and HF, after overwhelming evidence in heart failure with reduced ejection fraction and end-stage heart failure, while clinical trials are still lacking in patients with preserved ejection. Guideline-medical therapy of heart failure decreases the incidence of atrial fibrillation and the progression of atrial myopathy. Based on the current evidence, management of patients with both HF and AF should be include early optimization of comorbidity control, guideline-medical therapy for heart failure, and rhythm control preferentially through catheter ablation in properly selected patients.
心房颤动和心力衰竭常同时存在。本文讨论了心房颤动和心力衰竭的合并症、两者之间的双向联系，以及这些共存疾病的治疗新进展。
导管消融治疗射血分数降低的心力衰竭和终末期心力衰竭患者，获得了 1A 类推荐，而在射血分数保留的心力衰竭患者中，临床试验仍缺乏证据。心力衰竭的指南指导药物治疗可降低心房颤动的发生率和心房心肌病的进展。根据目前的证据，心力衰竭合并心房颤动患者的管理应包括早期优化合并症控制、心力衰竭指南指导药物治疗，以及在适当选择的患者中优先进行导管消融的节律控制。
