Jung Min-Su, Park Hyoung-Seob
Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu, Korea.
Korean J Intern Med. 2025 Jul;40(4):533-545. doi: 10.3904/kjim.2024.284. Epub 2025 Jul 1.
Atrial fibrillation (AF) and heart failure (HF) frequently coexist with other cardiovascular conditions and adversely affect each other. Over the past few decades, there have been therapeutic advances in AF and HF; however, whether rate-control or rhythm-control is the superior approach for these patients remains controversial. Additionally, there is debate regarding whether antiarrhythmic drug therapy or ablation is the optimal strategy for rhythm-control. The outcomes of AF ablation have improved, and several studies have assessed the potential benefits of AF ablation in patients with HF. The positive impact of catheter ablation in patients with AF and impaired left ventricular (LV) systolic function extends beyond rhythmic outcomes and may result in LV function improvement. This review provides a brief overview of this topic and summarizes several prospective randomized trials that have shown important clinical outcomes comparing AF ablation and non-ablation treatment options in patients with AF and HF so as to provide improved treatment guidance.
心房颤动(AF)与心力衰竭(HF)常与其他心血管疾病并存,且相互产生不良影响。在过去几十年中,AF和HF的治疗取得了进展;然而,对于这些患者,心率控制还是节律控制是更好的方法仍存在争议。此外,关于抗心律失常药物治疗还是消融术是节律控制的最佳策略也存在争论。AF消融术的效果有所改善,多项研究评估了AF消融术对HF患者的潜在益处。导管消融术对AF和左心室(LV)收缩功能受损患者的积极影响不仅限于节律方面的结果,还可能导致LV功能改善。本综述简要概述了该主题,并总结了几项前瞻性随机试验,这些试验显示了比较AF消融术与非消融治疗方案对AF和HF患者重要临床结果的情况,以便提供更好的治疗指导。