Heart failure and atrial flutter: a systematic review of current knowledge and practices
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 outco...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13526 |
| _version_ | 1828797516717490176 |
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| author | Michael J. Diamant Jason G. Andrade Sean A. Virani Pardeep S. Jhund Mark C. Petrie Nathaniel M. Hawkins |
| author_facet | Michael J. Diamant Jason G. Andrade Sean A. Virani Pardeep S. Jhund Mark C. Petrie Nathaniel M. Hawkins |
| author_sort | Michael J. Diamant |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T04:42:30Z |
| format | Article |
| id | doaj.art-9e8c30769e9041cc9fd6d9159ba2eaba |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-12T04:42:30Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-9e8c30769e9041cc9fd6d9159ba2eaba2022-12-22T00:37:46ZengWileyESC Heart Failure2055-58222021-12-01864484449610.1002/ehf2.13526Heart failure and atrial flutter: a systematic review of current knowledge and practicesMichael J. Diamant0Jason G. Andrade1Sean A. Virani2Pardeep S. Jhund3Mark C. Petrie4Nathaniel M. Hawkins5Division of Cardiology Royal Columbian Hospital New Westminster British Columbia CanadaDivision of Cardiology University of British Columbia Vancouver British Columbia CanadaDivision of Cardiology University of British Columbia Vancouver British Columbia CanadaBHF Cardiovascular Research Centre University of Glasgow Glasgow UKBHF Cardiovascular Research Centre University of Glasgow Glasgow UKDivision of Cardiology University of British Columbia Vancouver British Columbia CanadaAbstract 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.https://doi.org/10.1002/ehf2.13526Heart failureLeft ventricular systolic dysfunctionAtrial flutterArrhythmiaCatheter ablationSystematic review |
| spellingShingle | Michael J. Diamant Jason G. Andrade Sean A. Virani Pardeep S. Jhund Mark C. Petrie Nathaniel M. Hawkins Heart failure and atrial flutter: a systematic review of current knowledge and practices ESC Heart Failure Heart failure Left ventricular systolic dysfunction Atrial flutter Arrhythmia Catheter ablation Systematic review |
| title | Heart failure and atrial flutter: a systematic review of current knowledge and practices |
| title_full | Heart failure and atrial flutter: a systematic review of current knowledge and practices |
| title_fullStr | Heart failure and atrial flutter: a systematic review of current knowledge and practices |
| title_full_unstemmed | Heart failure and atrial flutter: a systematic review of current knowledge and practices |
| title_short | Heart failure and atrial flutter: a systematic review of current knowledge and practices |
| title_sort | heart failure and atrial flutter a systematic review of current knowledge and practices |
| topic | Heart failure Left ventricular systolic dysfunction Atrial flutter Arrhythmia Catheter ablation Systematic review |
| url | https://doi.org/10.1002/ehf2.13526 |
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