Co-morbidity (HFrEF and HFpEF): atrial fibrillation

Heart failure and atrial fibrillation are conditions that pose considerable burdens on current and future healthcare, with high morbidity and mortality, frequent hospital admissions, and poor patient quality of life. The two conditions share many underlying pathophysiological mechanisms and common risk factors, which include each other. Hence these conditions often coexist, leading to even worse prognosis and challenges in management. The evidence base for heart failure treatments is limited in patients with concomitant atrial fibrillation, and atrial fibrillation management is often more difficult in the context of heart failure. Nearly all patients will benefit from oral anticoagulation, and yet many patients do not receive this important prognostic therapy in clinical practice. Prevention of incident atrial fibrillation is clearly an important target in heart failure patients, and can be achieved with appropriate guideline-recommended heart failure therapy. There is a huge opportunity for further research in patients with combined heart failure and atrial fibrillation, to improve patient well-being and long-term outcomes.