Atrial Fibrillation Management with Guideline-Directed Medical Therapy and Comorbidity Treatment in Heart Failure Patients.

Atrial myopathy is the underlying pathophysiological substrate of atrial fibrillation and contributes to the risk of heart failure as well. Atrial myopathy is caused by classic risk factors such as obesity, inflammation, diabetes, hypertension, and frequent alcohol use, in addition to structural heart and lung diseases that cause atrial pressure or volume overload. An optimal management of atrial fibrillation includes careful assessment of contributors to atrial myopathy, which can be treated by guideline-recommended medical therapies for heart failure, adequate control of congestion, and treatment of comorbid conditions such as sleep apnea syndrome. This approach works synergistically with rhythm control.