Key result
GDMT reduces incident AF in HF and remains beneficial despite AF worsening overall prognosis.
Why the study?
AF and HF frequently coexist and worsen outcomes, while GDMT for HF can impact AF incidence and AF can alter the efficacy of GDMT components.
How does guideline-directed medical therapy for heart failure affect the prevention of atrial fibrillation, and how does atrial fibrillation influence the efficacy of guideline-directed medical therapy?
How does guideline-directed medical therapy for heart failure affect the prevention of atrial fibrillation, and how does atrial fibrillation influence the efficacy of guideline-directed medical therapy?
This review highlights the bidirectional relationship between atrial fibrillation and heart failure, emphasizing how GDMT affects AF incidence and how AF influences GDMT efficacy.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Atrial fibrillation (AF) and heart failure (HF) are common cardiovascular conditions that frequently coexist. Among patients with HF, more than one-half also have AF. Both are associated with significant morbidity and mortality.”
Supports GDMT in HF-AF; leaves open efficacy variation by EF and needs prospective trials.
Atrial fibrillation (AF) and heart failure (HF) are common cardiovascular conditions that frequently coexist. Among patients with HF, more than one-half also have AF. Both are associated with significant morbidity and mortality. Moreover, the prevalence of each is increasing globally, and this trend is expected to continue owing to an aging population and increased life expectancy. Diagnosis of AF in a patient with HF is associated with greater symptom burden, more frequent hospitalizations, and a worse prognosis. Guideline-directed medical therapy (GDMT) for HF can affect the incidence of AF. Once present, AF can influence the efficacy of some components of GDMT for HF. In this review, we discuss the effect of GDMT for HF across the spectrum of ejection fraction on prevention of AF as well as the benefit of GDMT in patients with vs without AF.
Journal, society, and media accounts. Useful signal, not independent expert judgment.
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Newman et al. (2024) conducted a review in Heart failure and atrial fibrillation. Guideline-directed medical therapy was evaluated. Guideline-directed medical therapy for heart failure can reduce the incidence of atrial fibrillation, and while AF worsens prognosis, GDMT remains beneficial though its efficacy may vary.
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