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Heart failure affects 1-2% of the general population, but its frequency increases to 10% in people >70 years of age.

In addition to old age, recognized risk factors include coronary artery disease, hypertension, valvular heart disease, viral myocarditis, cardiotoxic drugs (e.g., certain cancer treatments) and genetic causes.

Patients with heart failure typically complain of dyspnea (shortness of breath), easy fatigue, and edema (swelling) in the legs. In recent years, remarkable progress has been made in understanding the syndrome, resulting in four main categories of drugs now available, the use of which has been shown to improve the prognosis and quality of life of patients.

Also important is the contribution of implantable defibrillators in reducing sudden death due to malignant tachyarrhythmias. Finally, when left bundle branch block coexists, cardiac resynchronization therapy with the implantation of biventricular pacemakers has brought about a real revolution, helping a significant proportion of patients to return to full activity.

Atrial fibrillation is the most common arrhythmia in adults. One in three Europeans aged 55 will experience atrial fibrillation during their lifetime. Atrial fibrillation is responsible for 20-30% of ischemic strokes, while 20-30% of patients with atrial fibrillation also suffer from heart failure. Atrial fibrillation can cause or worsen pre-existing heart failure.

In the early stages, patients complain of “flutter” or easy fatigue lasting minutes or a few hours, and then the atrial fibrillation is called paroxysmal. Progressively, it becomes persistent (episodes lasting >7 days) and in order to restore the normal rhythm, medical intervention (e.g. electrical conversion) is usually required.

Today, it is understood that early treatment of arrhythmia improves the prognosis of patients. Treatment options include antiarrhythmic drugs and ablation. Unfortunately, the available drugs are only moderately effective, while their long-term use carries risks.

In contrast, invasive treatment is the most effective and safe method in combating disease recurrences and reducing the overall burden of arrhythmia. Ablation is performed using specialized catheters, which are inserted through the femoral vein and advanced to the pulmonary vein orifices. There, energy is applied to destroy the ectopic electrical tissue responsible for introducing the arrhythmia.

The method is particularly effective in patients without long-standing atrial fibrillation. It is performed under local anesthesia and sedation (less often under general anesthesia) and requires an overnight stay in the clinic.