Atrial fibrillation (AF) and heart failure (HF)—specifically, heart failure with reduced ejection fraction (HFrEF)—often coexist, and each contributes to the propagation of the other. This relationship extends from the mechanistic and physiological to clinical syndromes, quality of life, and long-term cardiovascular outcomes. The risk factors for AF and HF overlap and create a critical opportunity to prevent adverse outcomes among patients at greatest risk for either condition. Increasing recognition of the linkages between AF and HF have led to widespread interest in designing diagnostic, predictive, and interventional strategies targeting all aspects of disease, from identifying genetic predisposition to addressing social determinants of health. Advances across this spectrum culminated in updated multisociety guidelines for management of AF, which includes specific consideration of comorbid AF and HF. This review expands on these guidelines by further highlighting relevant clinical trial findings and providing additional context for the evolving recommendations for management in this important and growing population.

中文翻译：

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心房颤动和射血分数降低的心力衰竭：对老问题的新评估


心房颤动 (AF) 和心力衰竭 (HF)，特别是射血分数降低的心力衰竭 (HFrEF)，通常同时存在，并且两者都会促进对方的传播。这种关系从机制和生理学延伸到临床综合征、生活质量和长期心血管结局。 AF 和 HF 的危险因素重叠，为预防这两种疾病风险最大的患者产生不良后果创造了重要机会。人们越来越认识到 AF 和 HF 之间的联系，这引起了人们对设计针对疾病各个方面的诊断、预测和干预策略的广泛兴趣，从识别遗传易感性到解决健康的社会决定因素。这一领域的进步最终导致了更新的多社会 AF 管理指南，其中包括对合并 AF 和 HF 的具体考虑。本综述进一步强调了相关的临床试验结果，并为这一重要且不断增长的人群不断发展的管理建议提供了额外的背景，从而扩展了这些指南。