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Cardiovascular biomarkers in patients with acute decompensated heart failure randomized to sacubitril-valsartan or enalapril in the PIONEER-HF trial Surgery Does Not Improve Survival in Patients With Isolated Severe Tricuspid Regurgitation Cost-Effectiveness of Different Durations of Dual-Antiplatelet Use After Percutaneous Coronary Intervention Consensus from the 5th European Bifurcation Club meeting Phenotypic Refinement of Heart Failure in a National Biobank Facilitates Genetic Discovery Intravascular ultrasound predictors for edge restenosis after newer generation drug-eluting stent implantation Effect of Luseogliflozin on Heart Failure With Preserved Ejection Fraction in Patients With Diabetes Mellitus Myofibroblast Phenotype and Reversibility of Fibrosis in Patients With End-Stage Heart Failure Titration of Medical Therapy for Heart Failure With Reduced Ejection Fraction Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients

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.