20.500.12556/DiRROS-27882 Complexities of treating co-morbidities in heart failurewith preserved ejection fraction Atrial fibrillation and heart failure with preserved ejection fraction (HFpEF) are frequent concomitant diseases sharing several pathophysiological mechanisms leading to structural remodelling of both atria and ventricles. We present a case of an HFpEF patient with rapid atrial fibrillation who remained symptomatic even after successful cardioversion, initiation of antiarrhythmic therapy, and treatment of comorbidities. Due to asymmetric septal hypertrophy, the stress test was performed to exclude outflow tract obstruction and revealed a low basal heart rate with significant chronotropic insufficiency. In addition to SGLT2 initiation, the beta-blocker dose was reduced, and amiodarone was discontinued. This therapy modification led to a marked improvement in exercise capacity, significant reduction of palpitations, reduction of NT-proBNP, and signs of a decreased left ventricular filling pressure with reverse remodelling of LA. This case shows the importance of both individual tailoring of medical therapy and chronotropic insufficiency in HFpEF patients atrial fibrillation heart failure heart rate sodium-glucose transporter 2 inhibitors true false true Angleški jezik Ni določen Neznano 2026-02-26 14:24:15 2026-02-26 14:24:15 2026-02-27 03:58:46 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis vira z dne 31. 3. 2025; str. 3425-3429 iss. 5 Vol. 11 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 61 2055-5822 10.1002/ehf2.14897 230909187 RAZ_Zlahtic_Tadej_2024.pdf RAZ_Zlahtic_Tadej_2024.pdf 1 B2F22D82FB703B6A205EBEB411BAAAC2 e32227c9358c1a98910aa3d6a64e0b9774bf60db35105472de1f6f51dc68e148 973fd15b-1316-11f1-9cb0-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=41035 https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.14897 1 732ddeb1-1316-11f1-9cb0-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=41034 Univerzitetni klinični center Ljubljana 0 0 0