2014AHA/ACC/HRS房颤管理指南

Patients with HF are more likely than the general population to develop AF, and there is a direct relationship between the NYHA class and prevalence of AF in patients with HF, progressing from 4% in those who are NYHA class I to 40% in those who are NYHA class IV. AF is a strong independent risk factor for subsequent development of HF as well. In addition to those with HF and depressed EF, patients with HF due to diastolic dysfunction with HFpEF are also at greater risk for AF. HF and AF can interact to perpetuate and exacerbate each other through mechanisms such as rate-dependent worsening of cardiac function, fibrosis,and activation of neurohumoral vasoconstrictors. AF can worsen symptoms in patients with HF and conversely, worsened HF can promote a rapid ventricular response in AF.