The Optimal Management of Patients with Atrial Fibrillation and Acute Heart Failure in the Emergency Department

被引:2
作者
Velliou, Maria [1 ]
Sanidas, Elias [2 ]
Diakantonis, Antonis [1 ]
Ventoulis, Ioannis [3 ]
Parissis, John [1 ]
Polyzogopoulou, Effie [1 ]
机构
[1] Attikon Univ Hosp, Emergency Med Dept, Athens 12462, Greece
[2] Laikon Gen Hosp, Dept Cardiol, Athens 11527, Greece
[3] Univ Western Macedonia, Dept Occupat Therapy, Ptolemaida 50200, Greece
来源
MEDICINA-LITHUANIA | 2023年 / 59卷 / 12期
基金
英国科研创新办公室;
关键词
atrial fibrillation; acute heart failure; cardiogenic shock; emergency department; acute rate control; rhythm control; cardioversion; BETA-1-SELECTIVE BLOCKER LANDIOLOL; RHYTHM-CONTROL; RAPID ATRIAL; TACHYARRHYTHMIAS; VERNAKALANT; AMIODARONE; CARDIOVERSION; DYSFUNCTION; EFFICACY; OUTCOMES;
D O I
10.3390/medicina59122113
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Atrial fibrillation (AF) and acute heart failure (AHF) are two closely interrelated conditions that frequently coexist in a manifold manner, with AF serving either as the causative factor or as the consequence or even as an innocent bystander. The interplay between these two clinical conditions is complex, given that they share common pathophysiological pathways and they can reciprocally exacerbate each other, thus triggering a vicious cycle that worsens the prognosis and increases the thromboembolic risk. The optimal management of AF in the context of AHF in the emergency department remains a challenge depending on the time onset, as well as the nature and the severity of the associated symptoms. Acute rate control, along with early rhythm control, when indicated, and anticoagulation represent the main pillars of the therapeutic intervention. The purpose of this review is to elucidate the pathophysiological link between AF and AHF and accordingly present a stepwise algorithmic approach for the management of AF in AHF patients in the emergency setting.
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