Because of the bidirectional relationship between atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF), individuals with either condition require consideration of screening for the other. In this review, we summarize current evidence and rationale for screening for occult HFpEF in adults with clinical AF; and occult AF in patients with clinically recognized HFpEF. Assessment of pretest probability for occult HFpEF in symptomatic AF patients may help guide additional testing such as exercise right heart catheterization to diagnose HFpEF and guide HFpEF-specific therapies. In patients with HFpEF, AF screening will identify cases of occult AF where anticoagulation may decrease stroke risk, and correlation of previously unknown AF episodes with paroxysmal symptoms may prompt consideration for rhythm control. Therefore, screening may help clinicians understand the etiology of the often-overlapping symptoms, and it may help guide treatments to slow progression of both conditions and their complications.

中文翻译：

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筛查心房颤动中未识别的 HFpEF 和 HFpEF 中未识别的心房颤动。


由于心房颤动 (AF) 和射血分数保留的心力衰竭 (HFpEF) 之间的双向关系，患有任何一种疾病的个体都需要考虑对另一种疾病进行筛查。在这篇综述中，我们总结了临床 AF 成人中隐匿性 HFpEF 筛查的当前证据和基本原理；以及临床公认的 HFpEF 患者的隐匿性 AF。对有症状 AF 患者中隐匿性 HFpEF 的预测试概率进行评估可能有助于指导其他测试，例如练习右心导管插入术来诊断 HFpEF 并指导 HFpEF 特异性治疗。对于 HFpEF 患者，房颤筛查将识别隐匿性房颤病例，其中抗凝治疗可能会降低中风风险，并且先前未知的房颤发作与阵发性症状的相关性可能会促使考虑节律控制。因此，筛查可以帮助临床医生了解经常重叠的症状的病因，并且可以帮助指导治疗以减缓病情及其并发症的进展。