Computer Assisted Optimisation of Non-Pharmacological Treatment of Congestive Heart Failure and Supraventricular Arrhythmia

Cardiac disease is the most common disease worldwide. Atrial fibrillation (AF) and conges-tive heart failure (CHF) are two frequently encountered conditions in clinical practice [260]. In fact, AF is the most common sustained cardiac arrhythmia [197, 114]. It causes the high-est number of hospitalization and is associated with higher mortality, major clinical complica-tions, such as heart failure, acute myocardial infarction and stroke, and impaired quality of life [164, 243, 3, 242, 159, 100, 89, 69, 66, 71]. Congestive heart failure leads to an asynchronous con-traction of the ventricles and poses a high risk factor for sudden death [1]. Both pathologies can occur independently. However, CHF is often developed in patients with AF due to its adverse ef-fect on cardiovascular haemodynamics. On the other hand, AF can be induced by an asynchronous contraction of the ventricles as may be developed in CHF. The latter has become the most im-portant risk factor of AF in developed countries, as a result of ageing populations. An increase in the prevalence of both atrial fibrillation and congestive heart failure is occurring in part because of the demographic shift toward an aging population [272]. Approximately two thirds of patientswith CHF are > 65 years of age. They are likely to have AF as a coexistent complication. Epi-demiological surveys and large clinical trials in CHF provide strong evidence that AF is a marker of increased mortality [255]. AF by itself is not leading to death, mostly. The increased risk of thromboembolism and stroke, however, leads to most complications that then increase morbidityand mortality [241, 186, 179]. It is approximated that this arrhythmia will reach epidemic propor-tions over the next two decades [12]. In fact, AF is gaining in clinical an economic importance even today [164].