[Risk factors for heart failure in women: atrial fibrillation].

In patients with heart failure (HF) the prevalence of atrial fibrillation (AF) is higher than in the general population, and the risk of developing AF is greater in women than in men. The occurrence of AF in HF patients correlates with increased mortality and greater incidence of thromboembolic events, which seem to occur more frequently in women. The increased risk of bleeding during oral anticoagulant therapy associated with HF determines an underuse of anticoagulants in these patients, in particular in female subjects. Since mortality related to the use of antiarrhythmic drugs is increased in patients with AF and HF and the efficacy of both pharmacological and electrical cardioversion is lower than in patients without HF, rate control is the more frequently used therapeutic strategy. A higher incidence of cardiovascular events has been demonstrated particularly in women with HF and AF using a rhythm control approach. AF can induce HF and persistence over time of high rate AF may result in tachycardiomyopathy, a form of dilated cardiomyopathy characterized by severe left ventricular dysfunction.