Heart failure & cardiomyopathies

Characterizing Atrial Fibrillation in Patients with and Without Heart Failure Across the Ejection Fraction Spectrum: Incidence, Prevalence, and Treatment Strategies

Eur J Heart FailPublished Registry-based matched cohort study

Authors' conclusion

Atrial fibrillation prevalence, anticoagulant use, and AF-related procedures increased over time regardless of HF, with HF patients more likely receiving AF treatments. In HF, despite higher AF prevalence and incidence in HFpEF, AF treatment use remained modest

Study context

Population
Patients with heart failure (HF) (Swedish HF Registry, 2005–2021) and matched patients without HF50% with HF
Participants
195,106 patients
Exposure
HF vs no HF, across the ejection fraction (EF) spectrum
Outcome
AF incidence, prevalence and treatment strategies
Methodological detailsmatched 1:1 by sex, age and county of residence, Swedish HF Registry
  • Matched 1:1 by sex, age and county of residence
  • Swedish HF Registry

Main finding

As reported in the abstract

Incident AF · median follow-up 3.7 years
Each group vs Non-HFHazard ratio (95% CI)
HF86 210 patients without AF
2.76(2.45–3.12)
HFpEF
3.12(2.65–3.67)
HFrEF
2.68(2.34–3.06)
HFmrEF
2.53(2.17–2.94)

Observational data: associations, not effects.

Further findings

OutcomeHFNon-HF
AF prevalence, 2006 to 202157% to 58%8% to 11%

Atrial fibrillation (AF) treatments

HF patients, particularly HFrEF, more likely receiving AF treatments than those without HF
Over time, antiarrhythmic use decreased; rate control drugs, OAC use and AF-related procedures increased, regardless of HF and EF

Original publication

Characterizing Atrial Fibrillation in Patients with and Without Heart Failure Across the Ejection Fraction Spectrum: Incidence, Prevalence, and Treatment Strategies. Eur J Heart Fail. Published 1 August 2024. doi:10.1002/ejhf.3402

Summarised from the published abstract; every number is checked against it

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