Chronic Obstructive Pulmonary Disease and Atrial Fibrillation

An Interdisciplinary Perspective

Sami O. Simons; Adrian Elliott; Manuel Sastry; Jeroen M. Hendriks; Michael Arzt; Michiel Rienstra; Jonathan M. Kalman; Hein Heidbuchel; Stanley Nattel; Geertjan Wesseling; Ulrich Schotten; Isabelle C. van Gelder; Frits M.E. Franssen; Prashanthan Sanders; Harry J.G.M. Crijns; Dominik Linz


Eur Heart J. 2021;42(5):532-540. 

In This Article

Heart Failure as a Differential Diagnosis

In patients with dyspnoea, heart failure with preserved and reduced ejection fraction is an important differential diagnosis[42] and the work-up should include the determination of natriuretic peptides and echocardiography according to the Guideline of the European Society of Cardiology.[43] Reduced oxygen-extraction in the muscle, increased ventilatory demand and impaired pulmonary mechanical constraints, which have been described in patients with heart failure, contribute to exercise limitation, and could become even more relevant during AF.[44,45] Moreover, AF is associated with excessive ventricular rate responses and reduced maximum aerobic exercise capacity in patients with concomitant heart failure,[45,46] which may result in a less efficient gas exchange.