Patients with HF are at an increased risk for deterioration and stroke in the presence of AF. Studies have demonstrated that beta-blockers, such as carvedilol, for rate control reduce morbidity and mortality rates in patients with HF and reduced left ventricular ejection fraction. In addition, beta-blockers may improve left ventricular function and reduce hospitalization rates. The use of digoxin may be considered in patients with AF and HF who do not achieve the target heart rates or who are unable to tolerate beta-blockers.
According to the American Heart Association, the beneficial effect of cardiac ablation for AF compared with medical therapy on all-cause mortality has been observed predominantly among patients with NYHA class I and II HF.
The 2020 European Society of Cardiology AF guidelines recommend a resting heart rate of < 110 beats/min as an initial heart rate target for patients with AF but advocate for a stricter rate-control strategy in patients with reduced ejection fraction. American guidelines (American Heart Association/American College of Cardiology/Heart Rhythm Society) recommend < 80 beats/min at rest in symptomatic patients if possible.
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Cite this: Ioana Dumitru, Jeffrey J. Hsu. Fast Five Quiz: Heart Failure Comorbidities - Medscape - Dec 09, 2022.