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Open Access 08-11-2023 | Atrial Fibrillation

Device therapy for patients with atrial fibrillation and heart failure with preserved ejection fraction

Authors: Zixi Zhang, Yichao Xiao, Yongguo Dai, Qiuzhen Lin, Qiming Liu

Published in: Heart Failure Reviews | Issue 2/2024

Abstract

Device therapy is a nonpharmacological approach that presents a crucial advancement for managing patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). This review investigated the impact of device-based interventions and emphasized their potential for optimizing treatment for this complex patient demographic. Cardiac resynchronization therapy, augmented by atrioventricular node ablation with His-bundle pacing or left bundle-branch pacing, is effective for enhancing cardiac function and establishing atrioventricular synchrony. Cardiac contractility modulation and vagus nerve stimulation represent novel strategies for increasing myocardial contractility and adjusting the autonomic balance. Left ventricular expanders have demonstrated short-term benefits in HFpEF patients but require more investigation for long-term effectiveness and safety, especially in patients with AF. Research gaps regarding complications arising from left ventricular expander implantation need to be addressed. Device-based therapies for heart valve diseases, such as transcatheter aortic valve replacement and transcatheter edge-to-edge repair, show promise for patients with AF and HFpEF, particularly those with mitral or tricuspid regurgitation. Clinical evaluations show that these device therapies lessen AF occurrence, improve exercise tolerance, and boost left ventricular diastolic function. However, additional studies are required to perfect patient selection criteria and ascertain the long-term effectiveness and safety of these interventions. Our review underscores the significant potential of device therapy for improving the outcomes and quality of life for patients with AF and HFpEF.

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Title: Device therapy for patients with atrial fibrillation and heart failure with preserved ejection fraction
Authors: Zixi Zhang
Yichao Xiao
Yongguo Dai
Qiuzhen Lin
Qiming Liu
Publication date: 08-11-2023
Publisher: Springer US
Keywords: Atrial Fibrillation
Cardiac Resynchronization Therapy
Vagus Nerve Stimulation
Heart Failure
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Published in: Heart Failure Reviews / Issue 2/2024
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-023-10366-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Device therapy for patients with atrial fibrillation and heart failure with preserved ejection fraction

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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