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Transcatheter Aortic Valve Replacement During Pregnancy Provisional versus elective two-stent strategy for unprotected true left main bifurcation lesions: Insights from a FAILS-2 sub-study Quality of Life after Everolimus-Eluting Stents or Bypass Surgery for Treatment of Left Main Disease The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study Extracellular Vesicles From Epicardial Fat Facilitate Atrial Fibrillation Longitudinal Assessment of Vascular Function With Sunitinib in Patients With Metastatic Renal Cell Carcinoma Noninvasive Imaging for the Evaluation of Diastolic Function: Promises Fulfilled Proteomics to Improve Phenotyping in Obese Patients with Heart Failure with Preserved Ejection Fraction Combined use of OCT and IVUS in spontaneous coronary artery dissection Transcatheter Mitral Valve Replacement in Patients with Heart Failure and Secondary Mitral Regurgitation: From COAPT Trial

Review ArticleVolume 7, Issue 6, June 2019

JOURNAL:JACC: Heart Failure Article Link

Heart Failure and Atrial Fibrillation, Like Fire and Fury

MA Carlisle, M Fudim, AD DeVore et al. Keywords: atrial fibrillation; catheter ablation; heart failure; rate control; rhythm control

ABSTRACT


Heart failure and atrial fibrillation are 2 common cardiovascular disorders that frequently complicate one another and exert a significant detrimental effect on cardiovascular health and well-being. Both heart failure and atrial fibrillation continue to increase in prevalence as the risk factors underlying each condition become more common. This review encompasses what is currently known about the epidemiology and pathophysiology of these comorbidities along with incorporation of landmark trials that have contributed to current guidelines. The focus is on clinically relevant considerations, including the contribution of inflammation in the pathophysiology of atrial fibrillation and heart failure. We explore the emerging role of catheter ablation relative to medical therapy in the management of heart failure with reduced ejection fraction, along with indications for biventricular pacing modalities in cardiac resynchronization therapy. We discuss current guideline-directed therapies and how practice models and national recommendations will likely change based on the most recent randomized controlled trials.