In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Heart failure and atrial fibrilation

Atrial Fibrillation

This was a joint session of the ESC and the ACC. Heart failure (HF) and atrial fibrillation (AF) are epidemics. Their incidence increases rapidly with age,  and the annual incidence of new AF ranges between 2 and 5%, while prevalence of AF is correlated with increase in NYHA class. Both carry a high mortality and morbidity.

AF increases morbidity and mortality in heart failure patients and remains an independent predictor of mortality (w 1.5 to 1.9-fold increase in the Framingham trial). HF begets AF by mechanical changes, neurohormonal activation and electrical alteration, while AF begets HF by mechanical changes, loss of AV synchrony, and hemodynamic alteration.

The second speaker, Prof. Harry Crijns, Netherlands, spoke about the cure of AF and concluded that there is no cure for AF in the setting of HF. However, reversal of AF leads to remodeling of atrial and in some instances, ventricular functions. When pharmacological treatments fail, there are possibilities for interventional proceduresL: AV node ablation with RV pacing and more recently, biventricular pacing, or pulmonary vein isolation. All these procedures are effective, but long term efficacy remains unknown, particularly for pulmonary vein isolation and further studies are clearly needed.

The role of drugs was evaluated by Dr. Ezekowitz (USA). Many drugs are useful, but many others are under evaluation, particularly to control rhythm (dronedarone), and several drugs are being tested to prevent stroke. Fourteen drugs are currently being tested in total. However, these drugs will not be available before 12 months after the end of the control trials, which means probably at least 2 or 3 years from now.





Heart failure and atrial fibrilation

Notes to editor

This congress report accompanies a presentation given at the ESC Congress 2008. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.