Atrialfibrillationandchronicheartfailurewith preserved ejection fraction: clinical significance and treatment

The prevalence of atrial fibrillation (AF) in patients with heart failure (HF) is several times higher than in the general population. At least half of the patients with symptoms and signs of heart failure have preserved left ventricular ejection fraction (HFpEF). The main factor of developing HFpEF and, consequently, the structural and functional changes in the left atrium is left ventricular diastolic dysfunction. It has a particular significance in case of AF, resulting in significant deterioration in the quality and length of life of these patients. Maintaining atrial contribution to the filling ventricles can probably decrease symptoms and improve the prognosis of patients with AF and HFpEF. The strategy of ventricular rate control could be more successful with medications having favorable impact on central pulse wave contour and thereby slowing the progression of left ventricular diastolic dysfunction.

Key words

Atrial fibrillation, CHF with preserved EF.