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The Atrial Fibrillation–Heart Failure Interconnection: Challenges and Innovations in Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 1339

Special Issue Editors


E-Mail Website1 Website2
Guest Editor
1. Unità Operativa di Cardiologia, Ospedale di Circolo, ASST Settelaghi, Varese, Italy
2. Department of Medicine and Surgery, University of Insubria, Varese, Italy
Interests: atrial fibrillation; catheter ablation; cardiac electrophysiology; cardiac arrhythmia; ventricular dysfunction; myocardial remodeling; diastolic dysfunction; biomarkers; anti-arrhythmia agents; risk assessment; artificial intelligence; telemedicine

E-Mail Website
Guest Editor
1. Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
2. Robert M. Berne Cardiovascular Research Center and Department of Medicine, University of Virginia, Charlottesville, VA, USA
Interests: atrial fibrillation; catheter ablation; ventricular dysfunction; myocardial remodeling; diastolic dysfunction; biomarkers; anti-arrhythmia agents; risk assessment; artificial intelligence; telemedicine

Special Issue Information

Dear Colleagues,

This Special Issue, "The Atrial Fibrillation–Heart Failure Interconnection: Challenges and Innovations in Diagnosis and Treatment", aims to explore the complex relationship between atrial fibrillation (AF) and heart failure (HF), two common cardiovascular conditions that often coexist and mutually worsen their clinical course. The bidirectional influence between AF and HF poses diagnostic and therapeutic challenges, highlighting the need for a comprehensive understanding and management of their interplay.​

We invite you to contribute with original investigations or reviews exploring the pathophysiological mechanisms linking AF and HF, as well as advancements in diagnostic modalities and treatment strategies. Topics of interest include, but are not limited to, the role of catheter ablation in patients with concurrent AF and HF, the impact of rhythm versus rate control strategies, and the integration of new pharmacological agents. We also encourage submissions focusing on personalized medicine approaches, the use of technologies, and the management of comorbidities that influence the AF-HF nexus.​

This Special Issue seeks to enhance our understanding and management of patients affected by AF and HF and improve patient outcomes and quality of life.

Dr. Roberto De Ponti
Dr. Michele Golino
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • atrial fibrillation
  • catheter ablation
  • ventricular dysfunction
  • myocardial remodeling
  • diastolic dysfunction
  • biomarkers
  • anti-arrhythmia agents
  • risk assessment
  • artificial intelligence
  • telemedicine

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Published Papers (1 paper)

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Review

23 pages, 1663 KB  
Review
Preserved Ejection, Lost Rhythm: A Narrative Review of the Pathophysiology and Management of Heart Failure with Preserved Ejection Fraction and Concomitant Atrial Fibrillation
by Andrea Ballatore, Alan Poggio, Andrew P. Sullivan, Andrea Saglietto, Gaetano Maria De Ferrari and Matteo Anselmino
J. Clin. Med. 2026, 15(3), 969; https://doi.org/10.3390/jcm15030969 - 25 Jan 2026
Viewed by 1001
Abstract
Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) coexist in 40–60% of cases and mutually reinforce each other through adverse electrical, cellular, and functional remodelling. There is considerable overlap in signs and symptoms, and diagnosis may be challenging due to [...] Read more.
Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) coexist in 40–60% of cases and mutually reinforce each other through adverse electrical, cellular, and functional remodelling. There is considerable overlap in signs and symptoms, and diagnosis may be challenging due to nonspecific clinical presentations and chronic course. AF is clearly linked with worsening morbidity and mortality in HFpEF with higher rates of HF hospitalizations, HF progression, stroke, systemic embolism, and all-cause death. Optimal management of HFpEF-AF patients requires aggressive treatment of comorbidities and risk factor modification. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated consistent benefit with respect to HF hospitalizations, symptoms and exercise haemodynamics, and potential to reduce AF burden. Gastric inhibitory polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) agonists, mineralocorticoid receptor antagonists (MRAs), angiotensin receptor-neprilysin inhibitors (ARNIs), and statins may provide benefit in selected phenotypes, though evidence remains heterogeneous. A rhythm control strategy in the early clinical course of HFpEF might be a reasonable strategy to improve symptoms and delay both AF and HFpEF disease progression. Catheter ablation appears to improve exercise haemodynamics and quality of life, and observational data suggest it may reduce mortality and HF hospitalization, though current evidence is inconsistent and not yet definitive. Emerging device-based and molecular therapies could represent promising avenues for future research. Overall, early detection of AF, comprehensive risk-factor modification, and tailored rhythm-control strategies are central to improving outcomes in the HFpEF-AF overlap syndrome. Full article
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