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Apr 30, 2014

Treating Heart Failure Patients with an Abnormal Heart Rhythm

Adding aspirin to a treatment regimen does more harm than good for heart failure patients with atrial fibrillation.

Less is more when prescribing medication for heart failure patients with an irregular heartbeat, according to research published in the Journal of the American College of Cardiology.

This study included almost 37,500 Danish patients diagnosed with heart failure between 1997 and 2009. Upon enrolling into the study, about 20% of participants had a type of irregular heartbeat called atrial fibrillation, which is common among heart failure patients. After being followed for about three years during the study period, another 17% of participants went on to develop an abnormal heartbeat.

The goal of the study was to identify the ideal combination of anti-clotting medication for patients with atrial fibrillation. Atrial fibrillation greatly increases risk for blood clots and stroke, so anti-clotting medication is often prescribed to prevent these potentially life-threatening complications.

Over the study period, patients with heart failure and atrial fibrillation took a number of different medications to treat their conditions. Most patients with atrial fibrillation took a common anti-clotting medication known as a vitamin k antagonist, and some took aspirin on top of this standard therapy. After comparing outcomes, researchers found that standard therapy plus aspirin didn’t improve outcomes. In fact, adding aspirin to the treatment plan actually increased risk of bleeding—one of the most common complications associated with anti-clotting meds.

Based on these findings, adding aspirin to the treatment regimen for heart failure patients with atrial fibrillation may be unsafe. However, helping reduce risk of blood clots and stroke in atrial fibrillation patients is still top priority. Authors hope that with future research, we can continue to identify the best-possible therapies to improve outcomes for patients with heart failure and atrial fibrillation.
Read the full study in the Journal of the American College of Cardiology

Questions for You to Consider

  • What is atrial fibrillation?

  • Atrial fibrillation is an irregular heart rhythm caused by abnormal, chaotic electrical impulses in the heart’s upper chambers, the atria. These electrical impulses, which interfere with the heart’s natural pacemaker, fire so rapidly the atria cannot beat with a regular rhythm or squeeze out blood effectively. Instead, they merely quiver while the ventricles, the heart’s lower chambers, beat rapidly.
  • Why is atrial fibrillation common among heart failure patients?
  • Atrial fibrillation can lead to heart failure, which occurs when the heart can’t pump enough blood to the rest of the body. Patients with heart failure may also develop atrial fibrillation over time, which can worsen symptoms. For most patients with heart failure and atrial fibrillation, maintaining a normal heart rhythm and reducing risk of stroke are key treatment goals.

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AFib affects more than 3 million people in the United States.