心房颤动(atrial fibrillation,AF)和保留射血分数的心力衰竭(heart failure with preserved ejection fraction,HFpEF)是2种常见且经常共存的疾病,对心血管疾病的发病率和死亡率有重要影响。HFpEF的主要特征为心房纤维化和左心房肌病,AF可能是HFpEF的原因或结果。最近的数据表明,通过导管消融恢复窦性心律可能是一种改善AF-HFpEF疾病进展的干预措施,可减轻HFpEF的严重程度,降低AF负荷、整体再住院率和死亡率。本文将重点对AF-HFpEF的病理生理机制以及导管消融在这类患者中的作用和临床进展作一综述。
Clinical progress of catheter ablation in patients with atrial fibrillation and heart failure with preserved ejection fraction
Atrial fibrillation(AF)and heart failure with preserved ejection fraction(HFpEF)are 2 common and often coexistent conditions,and have significant impact on cardiovascular morbidity and mortality.HFpEF is characterized as atrial fibrosis and left atrial myopathy,and AF could be the cause or consequence of HFpEF.Recent data suggest that sinus rhythm restoration with catheter ablation may be a useful intervention to improve disease progression in AF-HFpEF,which could reduce HFpEF severity,decrease AF burden,overall rehospitalization rate and mortality.In the review,we will focus on the pathophysiology of AF-HFpEF,the role and clinical progress of catheter ablation in these patients.
Atrial fibrillationHeart failure with preserved ejection fractionLeft atrial myopathyCatheter ablationEpidemiology