Register
Forgot your password?

An integrated approach to the treatment of patients with atrial fibrillation and heart failure: contemporary strategies and perspectives

Authors: Sekretaryov Yu., Tembotova Zh.Kh.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

For correspondence:  Sign in or register.

Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2024-18-3-278-285

For citation: Sekretaryov Yu., Tembotova Zh.Kh. An integrated approach to the treatment of patients with atrial fibrillation and heart failure: contemporary strategies and perspectives. Creative Cardiology. 2024; 18 (3): 278–285 (in Russ.). DOI: 10.24022/1997-3187-2024-18-3-278-285

Received / Accepted:  17.06.2024 / 05.08.2024

Keywords: atrial fibrillation heart failure catheter ablation cardiac resynchronization therapy



Subscribe 🔒

 

Abstract

Cardiovascular diseases continue to be the leading cause of death and disability worldwide, with atrial fibrillation (AF) and heart failure (HF) being the two most common and interrelated conditions. Often, it remains unclear whether HF is a cause or a consequence of AF due to the complexity of the processes involved in both the maintenance of AF and the development of HF. This relationship underscorestheneed for effectivetreatmentas well asthedevelopmentofintegratedmanagement strategies for theseconditions.RhythmorratecontrolincombinationwithoptimalHFtherapyandanticoagulantsarethecornerstoneoftreating AF with concomitant HF. Recently, thanks to advancements in technology and a better understanding of the pathophysiology of AF and HF, new treatment methods have emerged aimed at improving the prognosis and quality of life for patients. In this article, we will examine the pathogenesis mechanisms of these diseases and analyze the latest achievements in the treatment of AF in patients with HF.

References

  1. Santhanakrishnan R., Wang N., Larson M.G., Magnani J.W., McManus D.D., Lubitz S.A. et al. Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016; 133 (5): 484–492. DOI: 10.1161/CIRCULATIONAHA.115.018614
  2. Mamas M.A., Caldwell J.C., Chacko S., Garratt C.J., Fath-Ordoubadi F., Neyses L. A meta-analysis of the prognostic significance of atrial fibrillation in chronic heart failure. Eur. J. Heart Fail. 2009; 11 (7): 676–683. DOI: 10.1093/eurjhf/hfp085
  3. Tereshchenko S.N., Galyavich A.S., Uskach T.M. Russian Society of Cardiology (RSC) 2020 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2020; 25 (11): 4083 (in Russ.). DOI: 10.15829/1560-4071-2020-4083
  4. Tsao C.W., Lyass A., Enserro D., Larson M.G., Ho J.E., Kizer J.R. et al. Temporal Trends in the Incidence of and Mortality Associated With Heart Failure With Preserved and Reduced Ejection Fraction. JACC Heart Fail. 2018; 6 (8): 678–685. DOI: 10.1016/j.jchf.2018.03.006
  5. Sartipy U., Dahlström U., Fu M., Lund L.H. Atrial fibrillation in heart failure with preserved, mid-range, and reduced ejection fraction. JACC Heart Fail. 2017; 5 (8): 565–574. DOI: 10.1016/j.jchf.2017.05.001
  6. Nicoli C.D., O’Neal W.T., Levitan E.B., Singleton M.J., Judd S.E., Howard G. et al. Atrial fibrillation and risk of incident heart failure with reduced versus preserved ejection fraction. Heart. 2022; 108 (5): 353–359. DOI: 10.1136/heartjnl-2021-319122
  7. Wyse D.G., Waldo A.L., DiMarco J.P., Domanski M.J., Rosenberg Y., Schron E.B. et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N. Engl. J. Med. 2002; 347 (23): 1825–1833. DOI: 10.1056/NEJMoa021328
  8. Roy D., Talajic M., Nattel S., Wyse D.G., Dorian P., Lee K.L. et al. Rhythm control versus rate control for atrial fibrillation and heart failure. N. Engl. J. Med. 2008; 358 (25): 2667–2677. DOI: 10.1056/NEJMoa0708789
  9. Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., Blomström-Lundqvist C. et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur. Heart J. 2021; 42 (5): 373–498. DOI: 10.1093/eurheartj/ehaa612
  10. Chen S., Pürerfellner H., Meyer C., Acou W.J., Schratter A., Ling Z. et al. Rhythm control for patients with atrial fibrillation complicated with heart failure in the contemporary era of catheter ablation: a stratified pooled analysis of randomized data. Eur. Heart J. 2020; 41 (30): 2863– 2873. DOI: 10.1093/eurheartj/ehz443
  11. Arakelyan M.G., Bockeria L.A., Vasilieva E.Yu., Golitsyn S.P., Golukhova E.Z., Gorev M.V. et al. 2020 Clinical guidelines for Atrial fibrillation and atrial flutter. Russian Journal of Cardiology. 2021; 26 (7): 4594 (in Russ.). DOI: 10.15829/1560-4071-2021-4594
  12. Ferguson J.D. Management of arrhythmias and device therapy in heart failure. In: Felker G.M., Mann D.L. (Eds.) Heart failure: a companion to braunwald’s heart disease. 4th ed. Elsevier; 2020: 549–567. DOI: 10.1016/C2016-0-04949-5
  13. Bockeria L.A., Shengelia L.D. Changes in the heart associated with atrial fibrillation. Part I. Cardiopathy of atrial fibrillation: new dilemmas and old problems. Annaly Aritmologii (Annals of Arrhythmology). 2016; 13 (3): 138–145 (in Russ.). DOI: 10.15275/annaritmol.2016.3.2
  14. Luong C., Barnes M.E., Tsang T.S. Atrial fibrillation and heart failure: cause or effect? Curr. Heart Fail. Rep. 2014; 11 (4): 463–470. DOI: 10.1007/s11897-014-0229-1
  15. Prabhu S., Costello B.T., Taylor A.J., Gutman S.J., Voskoboinik A., McLellan A.J.A. et al. Regression of diffuse ventricular fibrosis following restoration of sinus rhythm with catheter ablation in patients with atrial fibrillation and systolic dysfunction: a substudy of the CAMERA MRI Trial. JACC Clin. Electrophysiol. 2018; 4 (8): 999–1007. DOI: 10.1016/j.jacep.2018.04.013
  16. Kowallick J.T., Staab W., Schuster A., Backhaus S.J., Weber-Krüger M., Bauer L. et al. Reverse left ventricular structural remodeling after catheter ablation of atrial fibrillation in patients with preserved left ventricular function: Insights from cardiovascular magnetic resonance native T1 mapping. Heart Rhythm. 2019; 16 (3): 424–432. DOI: 10.1016/j.hrthm.2018.09.016
  17. Soulat-Dufour L., Lang S., Addetia K., Ederhy S., Adavane-Scheuble S., Chauvet-Droit M. et al. Restoring sinus rhythm reverses cardiac remodeling and reduces valvular regurgitation in patients with atrial fibrillation. J. Am. Coll. Cardiol. 2022; 79 (10): 951–961. DOI: 10.1016/j. jacc.2021.12.029
  18. Kotecha D., Flather M.D., Altman D.G., Holmes J., Rosano G., Wikstrand J. et al. Heart rate and rhythm and the benefit of beta-blockers in patients with heart failure. J. Am. Coll. Cardiol. 2017; 69 (24): 2885–2896. DOI: 10.1016/j.jacc.2017.04.001
  19. Bockeria L.A., Bzhikshiev Z.Yu., Gafurov F.S. Atrial fibrillation in patients with chronic heart failure: selecting the right patient and the optimal strategy. Annaly Aritmologii (Annals of Arrhythmology). 2020; 17 (3): 194–203 (in Russ.). DOI: 10.15275/annaritmol.2020.3.5
  20. Gorenek B., Halvorsen S., Kudaiberdieva G., Bueno H., Van Gelder I.C., Lettino M. et al. Atrial fibrillation in acute heart failure: a position statement from the Acute Cardiovascular Care Association and European Heart Rhythm Association of the European Society of Cardiology. Eur. Heart J. Acute. Cardiovasc. Care. 2020; 9 (4): 348–357. DOI: 10.1177/2048872619894255
  21. MacDonald M.R., Connelly D.T., Hawkins N.M., Steedman T., Payne J., Shaw M. et al. Radiofrequency ablation for persistent atrial fibrillation in patients with advanced heart failure and severe left ventricular systolic dysfunction: a randomised controlled trial. Heart. 2011; 97 (9): 740– 747. DOI: 10.1136/hrt.2010.207340
  22. Hunter R.J., Berriman T.J., Diab I., Kamdar R., Richmond L., Baker V. et al. A randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure (the CAMTAF trial). Circ. Arrhythm. Electrophysiol. 2014; 7 (1): 31–38. DOI: 10.1161/CIRCEP.113.000806
  23. Marrouche N.F., Brachmann J., Andresen D., Siebels J., Boersma L., Jordaens L. et al. Catheter ablation for atrial fibrillation with heart failure. N. Engl. J. Med. 2018; 378 (5): 417–427. DOI: 10.1056/NEJMoa1707855
  24. Prabhu S., Taylor A.J., Costello B.T., Kaye D.M., McLellan A.J.A., Voskoboinik A. et al. Catheter ablation versus medical rate control in atrial fibrillation and systolic dysfunction: the CAMERA-MRI Study. J. Am. Coll. Cardiol. 2017; 70 (16): 1949–1961. DOI: 10.1016/j. jacc.2017.08.041
  25. Sugumar H., Prabhu S., Voskoboinik A., Young S., Gutman S.J., Wong G.R. et al. Atrial remodeling following catheter ablation for atrial fibrillation-mediated cardiomyopathy: long-term follow-up of CAMERA-MRI Study. JACC Clin. Electrophysiol. 2019; 5 (6): 681–688. DOI: 10.1016/j.jacep.2019.03.009
  26. Packer D.L., Piccini J.P., Monahan K.H.,Al-Khalidi H.R., SilversteinA.P., Noseworthy P.A. et al.Ablation versus drug therapy for atrial fibrillation in heart failure: results from the CABANA Trial. Circulation. 2021; 143 (14): 1377–1390. DOI: 10.1161/CIRCULATIONAHA.120.050991
  27. Kirchhof P., Camm A.J., Goette A., Brandes A., Eckardt L., Elvan A. et al. Early rhythm-control therapy in patients with atrial fibrillation. N. Engl. J. Med. 2020; 383 (14): 1305–1316. DOI: 10.1056/NEJMoa2019422
  28. Rillig A., Magnussen C., Ozga A.K., Suling A., Brandes A., Breithardt G. et al. Early rhythm control therapy in patients with atrial fibrillation and heart failure. Circulation. 2021; 144 (11): 845–858. DOI: 10.1161/CIRCULATIONAHA.121.056323
  29. Parkash R., Wells G.A., Rouleau J., Talajic M., Essebag V., Skanes A. et al. Randomized ablation-based rhythm-control versus rate-control trial in patients with heart failure and atrial fibrillation: results from the RAFT-AF trial. Circulation. 2022; 145 (23): 1693–1704. DOI: 10.1161/CIRCULATIONAHA.121.057095
  30. Richter S., Di Biase L., Hindricks G. Atrial fibrillation ablation in heart failure. Eur. Heart J. 2019; 40 (8): 663–671. DOI: 10.1093/eurheartj/ehy778
  31. Stupakov S.I., Shafiev E.Kh. Treatment modalities in patients with chronic heart failure combined with atrial fibrillation. Annaly Aritmologii (Annals of Arrhythmology). 2016; 13 (1): 29–37 (in Russ.). DOI: 10.15275/annaritmol.2016.1.4
  32. Ponikowski P., Voors A.A., Anker S.D., Bueno H., Cleland J.G., Coats A.J. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur. J. Heart Fail. 2016; 18(8): 891–975. DOI: 10.1002/ejhf.592
  33. Cleland J.G., Daubert J.C., Erdmann E., Freemantle N., Gras D., Kappenberger L. et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N. Engl. J. Med. 2005; 352 (15): 1539–1549. DOI: 10.1056/NEJMoa050496
  34. Anand I.S., Carson P., Galle E., Song R., Boehmer J., Ghali J.K. et al. Cardiac resynchronization therapy reduces the risk of hospitalizations in patients with advanced heart failure: results from the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) trial. Circulation. 2009; 119 (7): 969–977. DOI: 10.1161/CIRCULATIONAHA.108.793273
  35. Avanesyan G.A., Filatov A.G., Yahyaev Ya.B. Individual approach to optimizing parameters for biventricular multipolar stimulation for the treatment of patients with chronic heart failure. Annaly Aritmologii (Annals of Arrhythmology). 2023; 20 (2): 70–76 (in Russ.). DOI: 10.15275/annaritmol.2023.2.1
  36. Healey J.S., Hohnloser S.H., Exner D.V., Birnie D.H., Parkash R., Connolly S.J. et al. Cardiac resynchronization therapy in patients with permanent atrial fibrillation: results from the Resynchronization for Ambulatory Heart Failure Trial (RAFT). Circ. Heart Fail. 2012; 5 (5): 566–570. DOI: 10.1161/CIRCHEARTFAILURE.112.968867
  37. Gasparini M., Leclercq C., Lunati M., Landolina M., Auricchio A., Santini M. et al. Cardiac resynchronization therapy in patients with atrial fibrillation: the CERTIFY study (Cardiac Resynchronization Therapy in Atrial Fibrillation Patients Multinational Registry). JACC Heart Fail. 2013; 1 (6): 500–507. DOI: 10.1016/j.jchf.2013.06.003
  38. Brignole M., Pentimalli F., Palmisano P., Landolina M., Quartieri F., Occhetta E. et al. AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS: the APAF-CRT mortality trial. Eur. Heart J. 2021; 42 (46): 4731–4739. DOI: 10.1093/eurheartj/ehab569

About Authors

  • Yuriy Sekretaryov, Cardiologist; ORCID
  • Zhanna Kh. Tembotova, Cand. Med. Sci., Senior Researcher, Cardiovascular Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Sort by