The management of atrial fibrillation in heart failure

被引:1
作者
Bala R. [1 ]
Callans D.J. [1 ]
机构
[1] Hospital of The University of Pennsylvania, Cardiovascular Division, Department of Electrophysiology, Philadelphia, PA 19104
关键词
Atrial Fibrillation; Right Ventricular; Amiodarone; Cardiac Resynchronization Therapy; Catheter Ablation;
D O I
10.1007/s11936-006-0053-3
中图分类号
学科分类号
摘要
The development of atrial fibrillation (AF) can greatly complicate the course of heart failure (HF). Although recent trials have indicated the nonsuperiority of a rhythm control strategy in the general population with AF, this may not apply to patients with HF. We feel strongly that AF be treated aggressively in patients with HF, defaulting toward an initial rhythm control strategy, to avoid the hemodynamic detriment of irregular rapid ventricular response and the development of tachycardia-related myopathy. The index episode is treated with cardioversion and antiarrhythmic therapy. If significant benefit is demonstrated, the rhythm control strategy is maintained, to the point of catheter ablation for AF if necessary. If there is no change in cardiac performance or symptoms after cardioversion, strict rate control is enforced, to the point of atrioventricular node ablation and pacing if necessary. Copyright © 2006 by Current Science Inc.
引用
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页码:325 / 333
页数:8
相关论文
共 36 条
[1]  
Kannel W.B., Abbott R.D., Savage D.D., Et al., Epidemiologic features of chronic atrial fibrillation: The Framingham study, N Engl J Med, 306, pp. 1018-1022, (1982)
[2]  
Maisel W.H., Stevenson L.W., Atrial fibrillation in heart failure: Epidemiology, pathophysiology, and rationale for therapy, Am J Cardiol, 91, (2003)
[3]  
Benjamin E.J., Wolf P.A., D'Agostino R.B., Et al., Impact on atrial fibrillation on the risk of death: The Framingham Heart Study, Circulation, 98, pp. 946-952, (1998)
[4]  
Ehrlich J.R., Nattel S., Hohnloser S.H., Atrial fibrillation and congestive heart failure: Specific considerations at the intersection of two common and important cardiac disease sets, J Cardiovasc Electrophysiol, 13, pp. 399-405, (2002)
[5]  
Carson P.E., Johnson G.R., Dunkman E.B., Et al., The influence of atrial fibrillation on prognosis in mild to moderate heart failure, Circulation, 87, SUPPL. VI, (1993)
[6]  
Crijns H.J., Tjeerdsma G., de Kam P.J., Et al., Prognostic value of the presence of atrial fibrillation in patients with advanced heart failure, Eur Heart J, 21, pp. 1238-1245, (2000)
[7]  
Mahoney P., Kimmel S., DeNofrio D., Et al., Prognostic significance of atrial fibrillation in patients at a tertiary medical center referred for heart transplantation because of severe heart failure, Am J Cardiol, 83, pp. 1544-1547, (1999)
[8]  
Dries D.L., Exeter D.V., Gersh B.L., Et al., Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: A retrospective analysis of the SOLVD trials, J Am Coll Cardiol, 32, pp. 695-703, (1998)
[9]  
Middlekauf H.R., Stevenson W.G., Stevenson L.W., Prognostic significance of atrial fibrillation in advanced heart failure: A study of 390 patients, Circulation, 84, pp. 40-48, (1991)
[10]  
Mathew J., Hunsberger S., Fleg J., Et al., Incidence, predictive factors, and prognostic significance of supraventricular tachyarrhythmias in congestive heart failure, Chest, 118, pp. 914-922, (2000)