Risk Stratification in Atrial Fibrillation and Congestive Heart Failure

  • G. Boriani
  • C. Camanini
  • A. Branzi
  • C. Rapezzi
Conference paper


Atrial fibrillation (AF) and heart failure are two common cardiac diseases, affecting 1%-2% of the population [1,2] with a prevalence that rises steeply with age. AF and heart failure are conditioned by common risk factors and frequently coexist [3]; indeed, the prevalence of left ventricular dysfunction and/or congestive heart failure among patients with AF may be as high as 40% [4], and in the Framingham Study the presence of congestive heart failure implied a 6.6-fold increased risk of developing AF in a 2-year period. On the other side, the strong association between AF and congestive heart failure is further attested by the high prevalence of AF found in major heart failure trials dealing with patients in more advanced NYHA functional classes [3].


Atrial Fibrillation Congestive Heart Failure Left Ventricular Dysfunction Diastolic Interval High Ventricular Rate 
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  1. 1.
    Kannel WB, Abbott RD, Savage DD, McNamara PM (1982) Epidemiologic features of chronic atrial fibrillation. The Framingham Study. N Engl J Med 306:1018–1022PubMedCrossRefGoogle Scholar
  2. 2.
    Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE (1995) The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med 98:476–484PubMedCrossRefGoogle Scholar
  3. 3.
    Khand AU, Rankin AC, Kaye GC, Cleland JG (2000) Systematic review of the management of atrial fibrillation in patients with heart failure. Eur Heart J 21:614–632PubMedCrossRefGoogle Scholar
  4. 4.
    Middlekauff HR, Stevenson WG, Stevenson LW (1991) Prognostic significance of atrial fibrillation in advanced heart failure. A study of 390 patients. Circulation 84:40–48PubMedCrossRefGoogle Scholar
  5. 5.
    Grogan M, Smith HC, Gersh BJ, Wood DL (1992) Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. Am J Cardiol 69:1570–1573PubMedCrossRefGoogle Scholar
  6. 6.
    Peters KG, Kienzle MG (1988) Severe cardiomyopathy due to chronic rapidly conduced atrial fibrillation: complete recovery after restoration of sinus rhythm. Am J Med 85:242–244PubMedCrossRefGoogle Scholar
  7. 7.
    Packer DL, Bardy GH, Worley SJ, Smith MS, Cobb FR, Coleman RE, Gallagher JJ, German LD (1986) Tachycardia-induced cardiomyopathy: a reversible form of left ventricular dysfunction. Am J Cardiol 57:563–570PubMedCrossRefGoogle Scholar
  8. 8.
    Gallagher JJ (1985) Tachycardia and cardiomyopathy: the chicken-egg dilemma revisited. J Am Coll Cardiol 6:1172–1173PubMedCrossRefGoogle Scholar
  9. 9.
    Shinbane JS, Wood MA, Jensen DN, Ellanbogen KA, Fitzpatrick AP, Scheinman MM (1997) Tachycardia-induced cardimyopathy: a review of animal models and clinical studies. J Am Coll Cardiol 29:709–715PubMedCrossRefGoogle Scholar
  10. 10.
    Iannini JP, Spinale FG (1996) The identification of contributory mechanisms for the development and progression of congestive heart failure in animal models. J Heart Lung Transplant 15:1138–1150PubMedGoogle Scholar
  11. 11.
    Whipple GH, Sheffield LT, Woodman EG (1962) Reversible congestive heart failure due to chronic rapid stimulation of the normal heart. Proc N Engl Cardiovasc Soc 20:39–40Google Scholar
  12. 12.
    Schumacher B, Luderitz B (1998) Rate issue in atrial fibrillation. Consequences of tachycardia and therapy for rate control. Am J Cardiol 82(8A):29N–36NCrossRefGoogle Scholar
  13. 13.
    Tomita M, Spinale FG, Crawford FA, Zile MR (1991) Changes in left ventricular volume, mass, and function during the development and regression of supraventricular tachycardia-induced cardiomyopathy. Disparity between recovery of systolic versus diastolic function. Circulation 83:635–644PubMedCrossRefGoogle Scholar
  14. 14.
    Ueng KC, Tsai TP, Tsai CK, Wu DJ, Lin CS, Lee SH, Chen SA (2001) Acute and long term effects of atrioventricular junction ablation and VVIR pacemaker in symptomatic patients with chronic lone atrial fibrillation and normal ventricular response. J Cardiovasc Electrophysiol 12:303–309PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • G. Boriani
    • 1
  • C. Camanini
    • 1
  • A. Branzi
    • 1
  • C. Rapezzi
    • 1
  1. 1.Institute of CardiologyUniversity of BolognaItaly

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