Features June 2016 Issue

Rhythm Control May Be Best for Afib in Heart Failure Patients

Individuals with heart failure and atrial fibrillation may have reduced exercise capacity with rate control, suggesting rhythm control is better.

SergeiKorolko | Thinkstock

Atrial fibrillation (afib) and heart failure both reduce the heart’s ability to pump enough blood to match the body’s needs. The decision whether to treat patients with both conditions with heart rate control or heart rhythm control can have profound effects on their quality of life and health. In a study presented at the 2016 American College of Cardiology Scientific Sessions, Cleveland Clinic cardiology fellow Mohamed Elshazly, MD, found that rate control often left the patients with reduced capacity to exercise. This was true even among patients who had preserved left ventricular function—a condition in which the left ventricle contracts normally while pumping, but doesn’t relax sufficiently to allow enough blood to enter in between beats.

Restoring normal rhythm led to improved exercise capacity, Dr. Elshazly says. “This (study) provides mechanistic evidence that a rhythmcontrol strategy may potentially improve peak exercise capacity and survival, a finding that requires future prospective appraisal in this patient population," he explains.

Comments (1)

Dr. Elshazly,
I am a cardiac heart failure patient at the Cleveland Clinic. My Cardiologist is Dr. James Young. My Electrophysiologist is Dr. Bruce Wilkoff.
Your article above is spot on with me.
I have had ICDs for the past 20 years. On the first was one that was installed(St. Luke's Hospital/Houston), a wire was never inserted into my heart attack damaged left ventricle. On 2/10/16 Dr. Wilkoff found an open vessel, and a live undamaged part of my left ventricle, and inserted a wire into it and my right ventricle.
The difference is absolutely amazing. I thought you might enjoy the email below I recently sent to Dr. Young:
Dr. Young,
In meeting with Dr. Tang and Barbara Gus 5/4/16 I told them, and showed them, how absolutely great I feel. I have never felt like this in 20 years. I feel like something was injected in my body and is trying to transform it.
I carry on long animated conversations without shortness of breath. I walk at a nice pace and easily kept up with Barbara, as she hustled to catch an elevator, without shortness of breath. I have a spring in my step. I laugh hardly. I told Barbara my mind felt like it was on speed as it raced to absorb everything in life. I was fascinated by everything Dr. Tang was telling me. All of our friends and my family who have seen me remark how dramatically, positively different I look and act. I could go on and on.
My body will never be able to keep up with my racing, absorbing, fascinated with everything, mind. Challenge keeping them in sync.
Best Regards,
Harold

Posted by: Harold | May 19, 2016 12:30 PM    Report this comment

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