Therapeutical considerations in associated atrial fibrillation and heart failure

Rev Med Chir Soc Med Nat Iasi. 2014 Jul-Sep;118(3):624-30.

Abstract

Atrial fibrillation is a supraventricular tachyarrhythmia very common in medical practice, often associated with heart failure. Pathophysiological relationship between atrial fibrillation and heart failure is in the attention of numerous case studies, being incomplete elucidated.

Material and methods: We made a retrospective study on patients with both diseases, hospitalized in Cardiovascular Rehabilitation Hospital, Iasi, during 01.01.2013 - 31.12.2013. The obtained data allowed the classification of patients according to gender distribution, age groups, area of origin, clinical aspects, and association with other diseases, instituted treatment and appreciation of CHADS2 score. Data interpretation was performed with appropriate statistical methods.

Results: We found a higher frequency of the disease among male patients, male: female ratio being 2:1; the most of the patients lived in urban area. The pick of diseases incidence was in patients over 65 years with a total percentage of 70.84% of cases. We noted that the most common symptoms were exertional dyspnea (in all patients), palpitations, dizziness, headache, fatigue, asthenia, dyspnea at rest and pain/chest pressure. In our study, the majority of patients received the beta-blocker--digoxin combination (46 patients, 40 patients respectively).

Conclusions: The coexistence of the two disorders could be explained by identifying common risk factors. Beta blockers should be the first therapeutic option in patients with chronic heart failure and atrial fibrillation because they have the effect of controlling heart rate and improve survival in patients with these disorders. Meanwhile, digoxin is a drug, only certain conditions of high accuracy monitoring; whose major clinical indications are heart failure and atrial rhythm disturbances.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / epidemiology
  • Digoxin / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Heart Failure / complications*
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Romania / epidemiology
  • Sex Distribution
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Anti-Arrhythmia Agents
  • Digoxin