Coronary heart disease and atrial fibrillation: a vicious cycle

Am J Physiol Heart Circ Physiol. 2021 Jan 1;320(1):H1-H12. doi: 10.1152/ajpheart.00702.2020. Epub 2020 Nov 13.

Abstract

The population suffering from coronary heart disease (CHD) complicated by atrial fibrillation (AF) is rising rapidly. A strong correlation between the two diseases has been reported, and the many common risk factors they share may play prominent roles in their development. In addition, CHD can directly promote the progression of AF by affecting reentry formation, focal ectopic activity, and neural remodeling. At the same time, AF also affects CHD through three aspects: 1) atherosclerosis, 2) the mismatch of blood supply and oxygen consumption, and 3) thrombosis. In conclusion, CHD and AF can aggravate each other and seem to form a vicious cycle. For patients with CHD complicated by AF, principal studies and guidelines have focused on antithrombotic treatment and rhythm control, which are paramount for these patients. Of note, our review sheds light on the strategies to break the cycle of the two diseases, which may be fundamental to treat these patients and optimize the benefit.

Keywords: atrial fibrillation; coronary heart disease; risk factors; treatment strategies; vicious cycle.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / physiopathology
  • Coronary Disease / drug therapy
  • Coronary Disease / epidemiology*
  • Coronary Disease / physiopathology
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Primary Prevention
  • Risk Assessment
  • Risk Factors
  • Secondary Prevention
  • Thrombosis / epidemiology*
  • Thrombosis / prevention & control

Substances

  • Anti-Arrhythmia Agents
  • Fibrinolytic Agents