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Pharmacological management of atrial fibrillation in patients with heart failure with reduced ejection fraction: review of current knowledge and future directions.

Publication ,  Journal Article
Grubb, A; Mentz, RJ
Published in: Expert Rev Cardiovasc Ther
February 2020

Introduction: Both heart failure with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) independently cause significant morbidity and mortality. The two conditions commonly coexist and AF in the setting of HFrEF is associated with worse mortality, hospitalizations, and quality of life compared to HFrEF without AF. Despite the large burden of these conditions, there is no clear optimal management strategy for when they occur together.Areas covered: This review focuses on the pharmacological management of AF in HFrEF. Studies were identified through PubMed search of relevant keywords. The authors review key clinical trials that have influenced management strategies and guidelines. The authors focus on the classes of drugs used to treat AF for both rate and rhythm control strategies including beta-blockers, digoxin, amiodarone, and dofetilide. Additionally, the authors discuss select non-antiarrhythmic medications that affect AF in HFrEF. The authors highlight the strengths and weakness of the data supporting the use of these medications and suggest future directions.Expert opinion: The pharmacological treatment of AF in HFrEF will need further refinement alongside the emerging role of catheter ablation. Novel HF medications and antiarrhythmics offer new tools to prevent the development of AF, as well as for rate and rhythm control strategies.

Duke Scholars

Published In

Expert Rev Cardiovasc Ther

DOI

EISSN

1744-8344

Publication Date

February 2020

Volume

18

Issue

2

Start / End Page

85 / 101

Location

England

Related Subject Headings

  • Stroke Volume
  • Humans
  • Heart Failure
  • Catheter Ablation
  • Cardiovascular System & Hematology
  • Atrial Fibrillation
  • Anti-Arrhythmia Agents
  • Adrenergic beta-Antagonists
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
 

Citation

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Grubb, A., & Mentz, R. J. (2020). Pharmacological management of atrial fibrillation in patients with heart failure with reduced ejection fraction: review of current knowledge and future directions. Expert Rev Cardiovasc Ther, 18(2), 85–101. https://doi.org/10.1080/14779072.2020.1732210
Grubb, Alex, and Robert J. Mentz. “Pharmacological management of atrial fibrillation in patients with heart failure with reduced ejection fraction: review of current knowledge and future directions.Expert Rev Cardiovasc Ther 18, no. 2 (February 2020): 85–101. https://doi.org/10.1080/14779072.2020.1732210.
Grubb, Alex, and Robert J. Mentz. “Pharmacological management of atrial fibrillation in patients with heart failure with reduced ejection fraction: review of current knowledge and future directions.Expert Rev Cardiovasc Ther, vol. 18, no. 2, Feb. 2020, pp. 85–101. Pubmed, doi:10.1080/14779072.2020.1732210.
Journal cover image

Published In

Expert Rev Cardiovasc Ther

DOI

EISSN

1744-8344

Publication Date

February 2020

Volume

18

Issue

2

Start / End Page

85 / 101

Location

England

Related Subject Headings

  • Stroke Volume
  • Humans
  • Heart Failure
  • Catheter Ablation
  • Cardiovascular System & Hematology
  • Atrial Fibrillation
  • Anti-Arrhythmia Agents
  • Adrenergic beta-Antagonists
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services