4.6 Article

Coronary heart disease and atrial fibrillation: a vicious cycle

Publisher

AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpheart.00702.2020

Keywords

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

Funding

  1. Natural Science Foundation of China [81470471]
  2. Natural Science Foundation of Shanghai [19ZR11440600]
  3. Clinical Research Innovation Plan of Shanghai General Hospital [CTCCR-2018C04]

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Coronary heart disease (CHD) complicated by atrial fibrillation (AF) is on the rise, with a strong correlation between the two diseases and common risk factors. CHD can promote the progression of AF, while AF also affects CHD through various mechanisms, creating a vicious cycle between the two diseases.
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.

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