Substrate for development of atrial fibrillation in patients with congestive heart failure: are we close to the answer?

摘要

Development of atrial fibrillation (AF) in patients with congestive heart failure (CHF) remains one of the leading causes of clinical deterioration. Approximately 15% to 20% of patients with CHF have AF, which is more common in patients with advanced cardiac disease and reaches 50% in patients with grade IV CHF according to the New York Heart Association. According to data from controlled clinical trials, the annual incidence of AF in patients with CHF ranges from 3% to 5%. Although analyses of the impact of AF on mortality in CHF trials show conflicting findings, new-onset AF during follow-up has consistently been associated with a poor prognosis and a greater than twofold increase in all-cause mortality.