» Articles » PMID: 38138216

The Optimal Management of Patients with Atrial Fibrillation and Acute Heart Failure in the Emergency Department

Overview
Publisher MDPI
Specialty General Medicine
Date 2023 Dec 23
PMID 38138216
Authors
Affiliations
Soon will be listed here.
Abstract

Atrial fibrillation (AF) and acute heart failure (AHF) are two closely interrelated conditions that frequently coexist in a manifold manner, with AF serving either as the causative factor or as the consequence or even as an innocent bystander. The interplay between these two clinical conditions is complex, given that they share common pathophysiological pathways and they can reciprocally exacerbate each other, thus triggering a vicious cycle that worsens the prognosis and increases the thromboembolic risk. The optimal management of AF in the context of AHF in the emergency department remains a challenge depending on the time onset, as well as the nature and the severity of the associated symptoms. Acute rate control, along with early rhythm control, when indicated, and anticoagulation represent the main pillars of the therapeutic intervention. The purpose of this review is to elucidate the pathophysiological link between AF and AHF and accordingly present a stepwise algorithmic approach for the management of AF in AHF patients in the emergency setting.

Citing Articles

Intravenous Landiolol for Rate Control in Supraventricular Tachyarrhythmias in Patients with Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis.

Nasoufidou A, Papazoglou A, Stachteas P, Karagiannidis E, Samaras A, Alexiou S J Clin Med. 2024; 13(6).

PMID: 38541908 PMC: 10971001. DOI: 10.3390/jcm13061683.

References
1.
Iwahashi N, Takahashi H, Abe T, Okada K, Akiyama E, Matsuzawa Y . Urgent Control of Rapid Atrial Fibrillation by Landiolol in Patients With Acute Decompensated Heart Failure With Severely Reduced Ejection Fraction. Circ Rep. 2021; 1(10):422-430. PMC: 7897576. DOI: 10.1253/circrep.CR-19-0076. View

2.
Forshay C, Michael Boyd J, Rozycki A, Pilz J . The Safety and Efficacy of Verapamil Versus Diltiazem Continuous Infusion for Acute Rate Control of Atrial Fibrillation at an Academic Medical Center. Hosp Pharm. 2021; 56(5):519-524. PMC: 8554608. DOI: 10.1177/0018578720925388. View

3.
Damasceno A, Mayosi B, Sani M, Ogah O, Mondo C, Ojji D . The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries. Arch Intern Med. 2012; 172(18):1386-94. DOI: 10.1001/archinternmed.2012.3310. View

4.
Oliva F, Sormani P, Contri R, Campana C, Carubelli V, Ciro A . Heart rate as a prognostic marker and therapeutic target in acute and chronic heart failure. Int J Cardiol. 2017; 253:97-104. DOI: 10.1016/j.ijcard.2017.09.191. View

5.
Triposkiadis F, Xanthopoulos A, Lampropoulos K, Briasoulis A, Sarafidis P, Skoularigis J . Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly. J Clin Med. 2023; 12(6). PMC: 10058400. DOI: 10.3390/jcm12062321. View