Treatment strategies for patients with atrial fibrillation and chronic heart failure

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Abstract

Atrial fibrillation (AF) is associated with significant morbidity and mortality and may lead to the development of chronic heart failure (CHF). Each condition predisposes to the other, requiring a careful choice of the treatment strategy. This article is devoted to the prevalence and prognostic implications of both diseases. The article presents data from meta-analyzes related to the management of this group of patients. The aspects of rhythm control strategy in AF and concomitant CHF are described according to the recent studies and clinical guidelines. The features of anticoagulant therapy in patients with AF and CHF are outlined. Much attention is given to the importance of the safety profile of the anticoagulant therapy in terms of the bleeding risk in patients with concomitant AF and CHF.

About the authors

Sergei N. Tereshchenko

National Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education

Email: tuskach@mail.ru
ORCID iD: 0000-0001-9234-6129

д-р мед. наук, проф., гл. науч. сотр. отд. заболеваний миокарда и сердечной недостаточности, зав. каф. кардиологии

Russian Federation, Moscow; Moscow

Tatiana M. Uskach

National Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: tuskach@mail.ru
ORCID iD: 0000-0003-4318-0315

д-р мед. наук, вед. науч. сотр. отд. заболеваний миокарда и сердечной недостаточности, проф. каф. кардиологии

Russian Federation, Moscow; Moscow

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2. Fig. 1. The relationship between the pathophysiological mechanisms of atrial fibrillation and chronic heart failure [11] (adapted).

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3. Fig. 2. Comparison of the incidence of strokes / systemic thromboembolism and major bleeding with apixaban, dabigatran and rivaroxaban [40] (adapted).

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