Traditional or Device Approach for the Management of Atrial Fibrillation in Patients with Heart Failure

  • Aurelio Quesada
  • Mónica Giménez
  • Victor Palanca
  • Javier Jiménez
  • José Roda


Atrial fibrillation (AF), the most prevalent sustained arrhythmia, is an increasingly common risk factor in patients with severe left ventricular dysfunction. Moreover, it is associated with a poor prognosis and reduced quality of life for patients with heart failure (HF) syndrome. Trials involving HF patients have shown that the prevalence of AF in such patients is high, over 20–40% [1, 2] and increases with progressive NYHA class. AF is a relevant factor in terms of the incidence of stroke, morbidity, refractory arrhythmic episodes, and number of hospitalizations. Moreover, the results of the GUSTO-III trial confirmed that AF is an independent factor for increased mortality after myocardial infarction [3]. A retrospective analysis in the Studies of Left Ventricular Dysfunction Prevention and Treatment Trials showed that patients with AF at baseline, compared to those in sinus rhythm, had significantly greater all-cause mortality (34 vs 23%), death attributed to pump failure (16.7 vs 9.4%), and were more likely to reach the composite end point of death or hospitalization for HF (45 vs 33%). The European GEM DR Evaluation [4] a lso detected a higher early mortality of patients with implanted cardioverter/defibrillators — a population with a high prevalence of HF and left ventricular dysfunction, related to episodes of AF.


Atrial Fibrillation Left Ventricular Ejection Fraction Pulmonary Vein Cardiac Resynchronization Therapy Atrial Fibrillation Patient 
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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Aurelio Quesada
    • 1
  • Mónica Giménez
    • 1
  • Victor Palanca
    • 1
  • Javier Jiménez
    • 1
  • José Roda
    • 1
  1. 1.Cardiac Electrophysiology and Arrhythmias Section, Department of CardiologyHospital General Universitario de ValenciaValenciaSpain

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