PMID- 12670636
OWN - NLM
STAT- MEDLINE
DCOM- 20030417
LR  - 20220408
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 91
IP  - 6A
DP  - 2003 Mar 20
TI  - Atrial fibrillation in heart failure: epidemiology, pathophysiology, and 
      rationale for therapy.
PG  - 2D-8D
AB  - Heart failure (HF) affects almost 5 million patients in the United States and is 
      a leading cause of morbidity and mortality. Atrial fibrillation (AF), like HF, 
      affects millions of patients and markedly increases in prevalence with age. As 
      the US population ages, the number of patients afflicted with HF and AF will 
      continue to grow. HF with preserved ejection fraction is particularly common in 
      the elderly population. The prevalence of AF in patients with HF increases from 
      <10% in those with New York Heart Association (NYHA) functional class I HF to 
      approximately 50% in those with NYHA functional class IV HF. The pathophysiologic 
      changes that occur in patients with HF and AF are complex and incompletely 
      understood. Alterations in neurohormonal activation, electrophysiologic 
      parameters, and mechanical factors conspire to create an environment in which HF 
      predisposes to AF and AF exacerbates HF. Mechanisms include atrial remodeling and 
      tachycardia-induced myopathy. The development of AF in HF appears to 
      independently predict death resulting from pump failure and total mortality. 
      Although the currently available therapeutic options for AF in patients with HF 
      are varied, their effect on prognosis remains unknown and is the subject of 
      ongoing clinical trials. It will be critical to define and plan therapies 
      specifically for those patients with AF, HF, and preserved ejection fraction in 
      addition to the population with low ejection fraction that has dominated previous 
      investigations.
FAU - Maisel, William H
AU  - Maisel WH
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts 02115, USA. wmaisel@partners.org
FAU - Stevenson, Lynne Warner
AU  - Stevenson LW
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Anticoagulants/therapeutic use
MH  - Atrial Fibrillation/*complications/epidemiology/etiology/physiopathology/therapy
MH  - Cardiomyopathies/etiology
MH  - Heart Failure/*complications/drug therapy/epidemiology/etiology/physiopathology
MH  - Humans
MH  - Incidence
MH  - Prevalence
MH  - Prognosis
MH  - Quality of Life
MH  - Stroke Volume
MH  - Tachycardia/complications/etiology
MH  - United States/epidemiology
RF  - 48
EDAT- 2003/04/03 05:00
MHDA- 2003/04/18 05:00
CRDT- 2003/04/03 05:00
PHST- 2003/04/03 05:00 [pubmed]
PHST- 2003/04/18 05:00 [medline]
PHST- 2003/04/03 05:00 [entrez]
AID - S0002914902033738 [pii]
AID - 10.1016/s0002-9149(02)03373-8 [doi]
PST - ppublish
SO  - Am J Cardiol. 2003 Mar 20;91(6A):2D-8D. doi: 10.1016/s0002-9149(02)03373-8.