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Atrial Fibrilasi+chf
Atrial Fibrilasi+chf
As a results:
- most international guidelines recommend rate control as the first-line therapy for AF in patients with HFrEF
- rhythm control only for those patients with ongoing symptoms secondary to AF despite rate control
Why the AAD treatment may not
improve outcomes in these studies?
1. Limited efficacy of AAD treatment to maintain sinus rhythm (only
+28% in DIAMOND CHF and +32% in AF-CHF)
2. The beneficial effects of maintaining sinus rhythm with AADs are
abrogated by the occurrence of adverse events, and in the case of
amiodarone, end organ toxicities.
Catheter Ablation
• Alternative to AAD for maintaining sinus rhythm in patients with paroxysmal and
persistent forms of AF
• Superior to AAD for achieving sinus rhythm both for patients who are refractory
to drugs or for first-line therapy (most trials not focused on on patients with
ventricular dysfunction.
• Safe procedure with a low rate of major complications
• Improvement in postablation ejection fraction (EF), quality of life (QoL), and
functional capacity in the AF and HFrEF population
QUESTIONS: The efficacy and safety of this procedure in patients with HFrEF
In this article, the authors review the available randomized data available to compare CA to medical therapy
alone in the AF and HF population as well as the unmet needs in this challenging population.
UNMET NEEDS FOR ATRIAL FIBRILLATION ABLATION IN
HEART FAILURE PATIENTS: WHAT CAN WE DO?