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Title: | Electrical management of heart failure: from pathophysiology to treatment | Authors: | Prinzen, Frits W. Auricchio, Angelo MULLENS, Wilfried Linde, Cecilia Huizar, Jose F. |
Issue Date: | 2022 | Publisher: | OXFORD UNIV PRESS | Source: | EUROPEAN HEART JOURNAL, | Status: | Early view | Abstract: | Electrical disturbances, such as atrial fibrillation (AF), dyssynchrony, tachycardia, and premature ventricular contractions (PVCs), are present in most patients with heart failure (HF). While these disturbances may be the consequence of HF, increasing evidence suggests that they may also cause or aggravate HF. Animal studies show that longer-lasting left bundle branch block, tachycardia, AF, and PVCs lead to functional derangements at the organ, cellular, and molecular level. Conversely, electrical treatment may reverse or mitigate HF. Clinical studies have shown the superiority of atrial and pulmonary vein ablation for rhythm control and AV nodal ablation for rate control in AF patients when compared with medical treatment. Ablation of PVCs can also improve left ventricular function. Cardiac resynchronization therapy (CRT) is an established adjunct therapy currently undergoing several interesting innovations. The current guideline recommendations reflect the safety and efficacy of these ablation therapies and CRT, but currently, these therapies are heavily underutilized. This review focuses on the electrical treatment of HF with reduced ejection fraction (HFrEF). We believe that the team of specialists treating an HF patient should incorporate an electrophysiologist in order to achieve a more widespread use of electrical therapies in the management of HFrEF and should also include individual conditions of the patient, such as body size and gender in therapy fine-tuning. | Notes: | Prinzen, FW (corresponding author), Maastricht Univ, Cardiovasc Res Inst Maastricht, Dept Physiol, POB 616, NL-6200 MD Maastricht, Netherlands. frits.prinzen@maastrichtuniversity.nl |
Keywords: | heart failure;heart failure;tachycardia;tachycardia;atrial fibrillation;atrial fibrillation;premature ventricular contractions;premature ventricular contractions;ventricular dyssynchrony;ventricular dyssynchrony;resynchronization therapy;resynchronization therapy;ablation;ablation | Document URI: | http://hdl.handle.net/1942/37107 | ISSN: | 0195-668X | e-ISSN: | 1522-9645 | DOI: | 10.1093/eurheartj/ehac088 | ISI #: | WOS:000767427900001 | Rights: | The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2023 |
Appears in Collections: | Research publications |
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Electrical management of heart failure_ from pathophysiology to treatment.pdf | Published version | 915.14 kB | Adobe PDF | View/Open |
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