The complex interaction between atrial fibrillation and heart failure in elderly patients

Submitted: February 15, 2019
Accepted: May 15, 2019
Published: June 4, 2019
Abstract Views: 2205
PDF: 1570
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Heart failure (HF) and atrial fibrillation (AF) often coexist. Subjects with permanent AF show the highest prevalence of HF. Patients with incident AF have HF in a great number of cases and, reciprocally, in patients with incident HF, an AF can be frequently found. The simultaneous presence of the two conditions is associated with mortality rates higher than those observed in individuals with only one or none of them. Interestingly, HF and AF could synergistically promote in elderly patients the development of disability and dementia. Inflammatory mechanisms coupled with changes of renin-angiotensin system, hormonal pathways and neuro-mediators could simultaneously promote left atrium remodeling and sustain both HF and AF. Beta-blockers and digoxin seem to have small therapeutic effect and limited influence on prognosis in these very complex patients. Sinus rhythm restoration could slow down the progression of disability in symptomatic subjects. Recent evidence seem to suggest that upstream therapy coupled with rehabilitation, and that AV node ablation associated with cardiac resynchronization therapy could benefit subjects with HF and AF. In conclusion, elderly patients simultaneously presenting problems of cardiac function and arrhythmia are an important challenge for geriatric medicine, and request important efforts to improve their functional profile and prognosis.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

How to Cite

Fumagalli, Stefano, Giulia Pelagalli, Marta Migliorini, Serena Boni, Francesca Nigro, Irene Marozzi, Simone Pupo, and Niccolò Marchionni. 2019. “The Complex Interaction Between Atrial Fibrillation and Heart Failure in Elderly Patients”. Monaldi Archives for Chest Disease 89 (2). https://doi.org/10.4081/monaldi.2019.1050.

Similar Articles

You may also start an advanced similarity search for this article.