Heart failure (and not only heart failure) and atrial fibrillation: An opening gap between evidence and practice

Abstract

Atrial fibrillation (AF) has become a major medical and socio-economic challenge. Restoration and maintenance of sinus rhythm is associated with an improved quality of life and prolonged survival; however, it is difficult to achieve in routine practice. This article addresses the role of antiarrhythmic drugs, AV junction ablation with cardiac pacing, and selective ablation while comparing them in the treatment of AF and heart failure. The issues of electric, mechanical, and structural myocardial remodeling and, possibly, reverse remodeling, and the potential of individual therapeutic methods to affect these processes are also discussed. Finally, the incidence of thromboembolic events after selective catheter ablation is compared with the efficacy of routine anticoagulation therapy.