Chapters authored
Atrial Fibrillation in Heart Failure: Rate or Rhythm Control Strategy
Atrial fibrillation and heart failure are intimately related as they shared the same risk factors, unsurprisingly they commonly coexist and complicate each other. Management of atrial fibrillation in heart failure is usually simplified into rate or rhythm control strategy, as each offers its advantages and limitations. Pharmacological rate and rhythm control strategy has been compared for the last decades; however, as more nonpharmacological approach raised as viable option has driven the management strategy discussion even further. On the other hand, heart failure understanding is also evolving and more detailed classification has been made based on left ventricular function. Justification for rate or rhythm control strategy should be individualized predicated on clinical phenotype. Moreover, the chosen strategy should be flexible and can be adjusted if the preferred strategy is ineffective.
Part of the book: Atrial Fibrillation
Left Atrial Appendage Occlusion: Current and Future
Patients with non-valvular atrial fibrillation (NVAF) are at an increased risk of ischemic stroke due to the risks of thrombus formation. The left atrial appendage (LAA) is shown to be “the culprit” of thromboembolic events in NVAF and is currently a therapeutic target to prevent stroke. The absolute benefit of oral anticoagulation in the management of NVAF to improve cardiovascular outcomes has been well established. However, some patients are not good long-term candidates for oral anticoagulation for many reasons, including risks of bleeding, noncompliant to oral anticoagulation (OAC). Left atrial appendage occlusion (LAAO) provides an attractive alternative to reduce the risk of stroke for those who are contraindicated to OAC therapy.
Part of the book: Atrial Fibrillation