Atrial Fibrillation and Heart Failure
Atrial Fibrillation
Atrial fibrillation (AF) is an irregular and often rapid heartbeat that can increase the risk of stroke, heart failure, and other complications. With AF, the heart's two upper chambers (the atria) beat chaotically and irregularly, out of coordination with the two lower chambers (the ventricles).
Heart Failure
Atrial fibrillation can lead to heart failure, a condition in which the heart can't pump enough blood to meet the body's needs. In this case, the atria quiver rapidly (fibrillate) instead of contracting and pumping blood to the ventricles. As a result, the heart can't pump out enough oxygen-rich blood to the rest of the body, leading to fatigue, shortness of breath, and other symptoms.
Types of Heart Failure Caused by Atrial Fibrillation
Atrial fibrillation can cause two types of heart failure: diastolic heart failure and systolic heart failure.
Diastolic heart failure occurs when the heart's lower chambers (the ventricles) can't relax and fill with enough blood during diastole (the relaxation phase of the heart cycle). This can lead to an enlarged left ventricle, as well as a decrease in cardiac output.
Systolic heart failure occurs when the heart's upper chambers (the atria) fibrillate rapidly and can't pump enough blood to the ventricles. This can lead to an enlarged right atrium and a decrease in cardiac output.
Treatment
The treatment of atrial fibrillation-related heart failure depends on the type of heart failure. Diastolic heart failure is typically treated with medications such as ACE inhibitors, beta-blockers, and diuretics. Systolic heart failure is typically treated with medications such as ACE inhibitors, beta-blockers, and angiotensin II receptor blockers. In some cases, a pacemaker or implantable cardioverter-defibrillator (ICD) may be necessary to help regulate the heart rate. Surgery may also be recommended in some cases.