Heart Failure Patients with Atrial Fibrillation: How Important Is It to Regularize Ventricular Rhythm?
Atrial fibrillation is the arrhythmia which is most frequently encountered in clinical practice and has a particularly high incidence in the elderly and in patients with organic heart disease. The classical treatment of this arrhythmia involves restoration of sinus rhythm, control of the ventricular rate and prevention of thromboembolic events. Recently, however, there has been a systematic evaluation of the probable hemodynamic and clinical benefit of regularizing the ventricular rhythm in patients with chronic atrial fibrillation in whom the restoration of sinus rhythm is deemed to be impossible.
KeywordsAtrial Fibrillation Heart Failure Patient Catheter Ablation Pacemaker Implantation Chronic Atrial Fibrillation
Unable to display preview. Download preview PDF.
- 2.Herbert WH (1973) Cardiac output and the varying R-R interval of atrial fibrillation. J Electrocardiol 6(2)131–135Google Scholar
- 3.Naito M, David D, Michelson EL, Schaffenburg M, Dreifus LS (1983) The hemodynamic consequences of cardiac arrhythmias: evaluation of the relative roles of abnormal atrioventricular sequencing, irregularity of ventricular rhythm and atrial fibrillation in a canine model. Am Heart J 106: 284–291PubMedCrossRefGoogle Scholar
- 5.Natale A, Zimerman L, Tomassoni G, Kearney M, Kent V, Brandon MJ, Newby K (1996) Impact on ventricular function and quality of life of transcatheter ablation of the atrioventricular junction in chronic atrial fibrillation with a normal ventricular response. Am J Cardiol 78: 1431–1433PubMedCrossRefGoogle Scholar
- 7.Natale A, Zimerman L, Newby KH, Pisano E, Fanelli R, Calleriza F, Reyes W (1997) AV node ablation and pacemaker implantation after withdrawal of effective rate-control medications for chronic atrial fibrillation: effect on quality of life and exercise performance. J Am Coll Cardiol 29(suppl A): 150A (abstr)Google Scholar
- 8.Rodriguez LM, Smeets LRM, Xie B, de Chillou C, Cheriex E, Pieters F, Metzger J, den Dulk K, Wellens HJJ (1993) Improvement in left ventricular function by ablation of atrioventricular nodal conduction in selected patients with lone atrial fibrillation. Am J Cardiol 72: 1137–1141PubMedCrossRefGoogle Scholar
- 10.Brignole M, Gianfranchi L, Menozzi C, Bottoni N, Bollini R, Lolli G, Oddone D, Gaggioli G (1994) Influence of atrioventricular junction radiofrequency ablation in patients with chronic atrial fibrillation and flutter on quality of life and cardiac performance. Am J Cardiol 74: 242–246PubMedCrossRefGoogle Scholar
- 12.Fitzpatrick AP, Kourouyan HD, Siu A, Lee RJ, Lesh MD, Epstein LM, Griffin JC, Scheinman MM (1996) Quality of life and outcomes after radiofrequency His-bundle catheter ablation and permanent pacemaker implantation: impact of treatment in paroxysmal and established atrial fibrillation. Am Heart J 131: 499–507PubMedCrossRefGoogle Scholar
- 13.Gosselink ATM, Blanksma PK, Crijns HJG, Van Gelder ISC, De Kam PI, Killege HL, Niemeijer MG, Lie KI, Meijler FL (1995) Left ventricular beat-to-beat performance in atrial fibrillation: contribution of Frank-Starling mechanism after short rather than long RR intervals. J Am Coll Cardiol 26: 1516–1521PubMedCrossRefGoogle Scholar
- 14.Ellenbogen KA, Thames MD, Mohanty PK (1990) New insights into pacemaker syndrome gained from hemodynamic, humoral and vascular responses during ventriculo-atrial pacing. Am J Cardiol 6: 131–135Google Scholar