The combination of AF and heart failure exacerbates the heart’s ability to pump efficiently further, and this may make the sufferer feel even worse.
The presence of AF increases the risk of someone suffering a stroke. When AF and heart failure are seen in the same person, this risk becomes much higher. If you are known to have AF together with heart failure, you and your clinician should discuss anticoagulation (sometimes known as blood thinning) to reduce the stroke risk.
AF in otherwise normal hearts can be difficult to treat because it is very patient-specific, but there are several medication and/or procedural options which are available to treat this condition.
With heart failure, AF becomes more difficult and risky to treat, and some of these drugs and procedures may even cause deterioration.
Thus, AF in association with heart failure causes real problems by:
- Increasing symptoms.
- Increasing risk of strokes.
- Being more diffcult to treat, with lower success rates and higher risks associated with treatments.
In the UK, cardiologists recognise AF and HF as a new ‘epidemic’ following an increase in diagnoses, and with cases set to rise in the future.
Whilst the combination of having AF and HF is a challenge, it is not all doom and gloom. Certainly, when AF first strikes a heart failure patient, the sudden change in heart rate and efficiency can make the patient feel terrible and may even provoke a stay in hospital. However, once balanced out, the outlook can be significantly better.
There are many specialist treatments that might be ordered, but because these depend on specific and complex details, and every patient is different, patients should not feel disappointed if they do not qualify for some of these strategies.
Lifestyle changes such as stopping smoking, light exercise and dietary adjustments can alleviate HF.
Some treatments are still regarded as experimental at the time of writing. The following may be considered appropriate:
- Cardioversion, usually in combination with powerful medication.
- Insertion of a pacemaker or ventricular assist devices.
- Pacemaker combined with ablation of the AV node (“ablate and pace”).
- Ablation, to address the AF.
The important point is that if a patient with HF develops AF, they should be assessed reasonably rapidly, even if they feel relatively well, as changes in treatment will almost certainly be necessary.
Further information can be found in AF Association information resources:
- Pacemaker and AV Node Ablation for AF patient information fact sheet.
- Ablation for atrial fibrillation patient information booklet.
- Cardioversion of atrial fibrillation patient information booklet.
