Heart failure and atrial flutter: a systematic review of current knowledge and practices

Diamant, M. J., Andrade, J. G., Virani, S. A., Jhund, P. S. , Petrie, M. C. and Hawkins, N. M. (2021) Heart failure and atrial flutter: a systematic review of current knowledge and practices. ESC Heart Failure, 8(6), pp. 4484-4496. (doi: 10.1002/ehf2.13526) (PMID:34505352) (PMCID:PMC8712920)

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Abstract

While the interplay between heart failure (HF) and atrial fibrillation (AF) has been extensively studied, little is known regarding HF and atrial flutter (AFL), which may be managed differently. We reviewed the incidence, prevalence, and predictors of HF in AFL and vice versa, and the outcomes of treatment of AFL in HF. A systematic literature review of PubMed/Medline and EMBASE yielded 65 studies for inclusion and qualitative synthesis. No study described the incidence or prevalence of AFL in unselected patients with HF. Most cohorts enrolled patients with AF/AFL as interchangeable diagnoses, or highly selected patients with tachycardia‐induced cardiomyopathy. The prevalence of HF in AFL ranged from 6% to 56%. However, the phenotype of HF was never defined by left ventricular ejection fraction (LVEF). No studies reported the predictors, phenotype, and prognostic implications of AFL in HF. There was significant variation in treatments studied, including the proportion that underwent ablation. When systolic dysfunction was tachycardia‐mediated, catheter ablation demonstrated LVEF normalization in up to 88%, as well as reduced cardiovascular mortality. In summary, AFL and HF often coexist but are understudied, with no randomized trial data to inform care. Further research is warranted to define the epidemiology and establish optimal management.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jhund, Dr Pardeep and Petrie, Professor Mark
Authors: Diamant, M. J., Andrade, J. G., Virani, S. A., Jhund, P. S., Petrie, M. C., and Hawkins, N. M.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:ESC Heart Failure
Publisher:Wiley
ISSN:2055-5822
ISSN (Online):2055-5822
Published Online:10 September 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in ESC Heart Failure 8(6): 4484-4496
Publisher Policy:Reproduced under a Creative Commons licence

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