Approaches to arrhythmias with Heart Failure

posted Jan 25, 2017, 11:31 PM by sourav ghosh
Director-Arrhythmia and Electrophysiology Service, Care Hospitals, Hyderabad, India

Patients with Heart Failure develop arrhythmias frequently. There are certain situations wherein Arrhythmias leads to development of Heart failure viz. tachycardiomyopathy. This review will address two common arrhythmias. a) atrial fibrillation and b) ventricular tachycardia and fibrillation.
Atrial fibrillation is a common in HF population and results in significant morbidity and mortality. It increases the risk of thromboembolic events and worsens heart failure. Effective rate control and use of anticoagulants in appropriately selected patients results in improved outcome. In patients persistent AF, a more definitive therapy involves catheter ablation of AF, or AV junction ablation and implantation of CRT.
Ventricular arrhythmias in heart failure are a prognostic marker for sudden death. There are certain situations where Ventricular arrhythmias are frequent like myocarditis, Lamin mutation etc. Optimal beta blocker therapy is useful to prevent sudden cardiac arrest in this population. Implantable cardioverter therapy and CRT-D are extremely useful to further minimize the risk of sudden cardiac death.