Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation

Atrial fibrillation (AF) and coronary artery disease are frequently associated and, when so, lead to a grim prognosis. Recent studies suggest the presence of interconnected pathophysiological pathways between the 2 conditions that can promote and aggravate each other, igniting a vicious cycle. Notwi...

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Main Authors: Georgiana Pintea Bentea, Brahim Berdaoui, Marielle Morissens, Philippe van de Borne, Jose Castro Rodriguez
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.037552
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author Georgiana Pintea Bentea
Brahim Berdaoui
Marielle Morissens
Philippe van de Borne
Jose Castro Rodriguez
author_facet Georgiana Pintea Bentea
Brahim Berdaoui
Marielle Morissens
Philippe van de Borne
Jose Castro Rodriguez
author_sort Georgiana Pintea Bentea
collection DOAJ
description Atrial fibrillation (AF) and coronary artery disease are frequently associated and, when so, lead to a grim prognosis. Recent studies suggest the presence of interconnected pathophysiological pathways between the 2 conditions that can promote and aggravate each other, igniting a vicious cycle. Notwithstanding, in contrast with the attention dedicated to the management of antithrombotic treatment, research on other aspects of coronary artery disease in AF is only recently gaining traction. The clinical impact of correct assessment of coronary artery stenosis in AF is especially high, due to the antithrombotic therapy imposed by both AF and coronary stenting. Until recently, an in‐depth characterization of coronary microcirculation in AF was lacking. However, contemporary studies indicate that coronary microvascular dysfunction is a frequent encounter in AF, possibly explaining the ischemic symptoms even in the absence of obstructive coronary artery disease and interfering with the use of pressure‐based indices to evaluate the hemodynamic significance of coronary artery stenosis. This comprehensive review addresses our current knowledge on coronary physiology in AF and its repercussion on the invasive management of coronary artery disease in this setting.
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series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
spelling doaj-art-7a2ee80583fc4ce5bf837487c558a68d2025-08-20T02:38:26ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-12-01132310.1161/JAHA.124.037552Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial FibrillationGeorgiana Pintea Bentea0Brahim Berdaoui1Marielle Morissens2Philippe van de Borne3Jose Castro Rodriguez4Department of Cardiology CHU Brugmann Brussels BelgiumDepartment of Cardiology CHU Brugmann Brussels BelgiumDepartment of Cardiology CHU Brugmann Brussels BelgiumDepartment of Cardiology CHU Erasme Brussels BelgiumDepartment of Cardiology CHU Brugmann Brussels BelgiumAtrial fibrillation (AF) and coronary artery disease are frequently associated and, when so, lead to a grim prognosis. Recent studies suggest the presence of interconnected pathophysiological pathways between the 2 conditions that can promote and aggravate each other, igniting a vicious cycle. Notwithstanding, in contrast with the attention dedicated to the management of antithrombotic treatment, research on other aspects of coronary artery disease in AF is only recently gaining traction. The clinical impact of correct assessment of coronary artery stenosis in AF is especially high, due to the antithrombotic therapy imposed by both AF and coronary stenting. Until recently, an in‐depth characterization of coronary microcirculation in AF was lacking. However, contemporary studies indicate that coronary microvascular dysfunction is a frequent encounter in AF, possibly explaining the ischemic symptoms even in the absence of obstructive coronary artery disease and interfering with the use of pressure‐based indices to evaluate the hemodynamic significance of coronary artery stenosis. This comprehensive review addresses our current knowledge on coronary physiology in AF and its repercussion on the invasive management of coronary artery disease in this setting.https://www.ahajournals.org/doi/10.1161/JAHA.124.037552atrial fibrillationcoronary artery diseaseinvasive management
spellingShingle Georgiana Pintea Bentea
Brahim Berdaoui
Marielle Morissens
Philippe van de Borne
Jose Castro Rodriguez
Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
atrial fibrillation
coronary artery disease
invasive management
title Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation
title_full Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation
title_fullStr Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation
title_full_unstemmed Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation
title_short Pathophysiology, Diagnosis, and Management of Coronary Artery Disease in the Setting of Atrial Fibrillation
title_sort pathophysiology diagnosis and management of coronary artery disease in the setting of atrial fibrillation
topic atrial fibrillation
coronary artery disease
invasive management
url https://www.ahajournals.org/doi/10.1161/JAHA.124.037552
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AT mariellemorissens pathophysiologydiagnosisandmanagementofcoronaryarterydiseaseinthesettingofatrialfibrillation
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