Anticoagulation for atrial fibrillation in heart failure patients:balancing between Scylla and Charybdis

摘要

The management of heart failure(HF)and atrial fibrillation(AF)in realworld practice remains a debating issue,while the number of HF patients with AF increase dramatically.While it is unclear if rhythm or rate control therapy is more beneficial and under which circumstances,anticoagulation therapy is the cornerstone of the AFHF patients’approach.VitaminK antagonists were the goldstandard during the past,but currently their usage is limited in specific conditions.Nonvitamin K oral anticoagulants(NOACs)have gained ground during the last ten years and considered as goldstandard of a wide spectrum of HF phenotypes.The current manuscript aims to review the current literature regarding the indications and the optimal choice and usage of NOACs in HF patients with AF.