Treating Patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and Atrial Fibrillation: We Need to Talk About the Fifth Pillar

Heart failure with reduced ejection fraction (HFrEF) is a complex clinical syndrome characterized by symptoms of dyspnea and worsening functional capacity resulting from reduced cardiac output in patients with left ventricular ejection fraction (LVEF) ≤40%. HFrEF represents an important public health problem, being one of the main causes of hospital admission, with high morbidity and mortality rates. Based on large randomized clinical trials, the standard treatment for patients with HFrEF until the late 1990s consisted of angiotensin-converting enzyme inhibitors (ACEIs) [...]