Remote monitoring and the twin epidemics of atrial fibrillation and chronic heart failure

Abstract

Atrial fibrillation † Heart failure † ICD † Remote monitoring Atrial fibrillation and heart failure are two epidemic pathological states that may affect the patient either alone or together. 1 The incidenceandprevalenceofbothoftheseincreasesexponentiallydayby daysincebotharesynergistictooneanother.Thus,itisveryfrequent to observe paroxysmal, persistent, or permanent atrial fibrillation causingheartfailurebecauseof associated highventricular rates sustained for very long periods and/or because of the loss of atrial contribution to cardiac output, which may be particularly important in patients with structural heart diseases. Conversely, more and more heartfailure patients change their rhythmfromsinusto atrialfibrillation, in any one of its different types, i.e. paroxysmal, persistent, or even permanent. Electrical transthoracic cardioversion and/or catheter ablation are frequently needed to restore sinus rhythm in patients with or without heart failure together with antiarrhythmic drug therapy and full anticoagulation to prevent arrhythmia recurrence and systemic embolism, respectively. Similarly, heart failure treatment is frequently necessary in many atrial fibrillation patients.