Arrhythmias & electrophysiologyResearch article
Development of atrial fibrillation in patients with heart failure and vice versa: incidence, risk factors, and their impact on survival
- UK Biobank participants with new-onset atrial fibrillation (AF) or heart failure (HF) (2006-22)
- Multivariable Cox models
Authors' conclusion
AF and HF strongly predispose to each other, with HF conferring a higher relative risk for incident AF. The coexistence of both diseases substantially increases mortality regardless of which disease developed first, emphasizing the need for strategies to prevent the development of HF in patients with AF and vice versa.
Study context
- Population
- UK Biobank participants with new-onset AF or HF (2006–22)participants with new-onset AF or HF
- Participants
- 31,374 participants
- Comparison
- The bidirectional risk and the impact of which disease develops first on mortality
Main finding
Developing HF
Adjusted hazard ratio
3.15
95% CI 3.0–3.31
By group
AF vs without AF
aHR 3.15 (95% CI 3.0–3.31)
As reported in the abstract
Further findings
| Outcome | Values | aHR (95% CI) | |
|---|---|---|---|
| Developing AF | HF 25.4 per 1000 person-years · without HF 2.27 per 1000 person-years | 2.75 (2.62–2.90) | |
| Mortality — AF before HF vs either condition alone · nearly four-fold increased risk | 3.8 (3.5–4.2) | ||
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Values | aHR (95% CI) |
|---|---|---|
| Mortality — HF before AF vs either condition alone · more than doubled risk; CI as printed | 2.0 (2.1–2.6) |
Risk of subsequent AF in HF patients compared with risk of AF patients developing HF
- HF patients had a higher risk of subsequent AF, compared with the risk of AF patients developing HF
- 31%
- P < .05
Mortality
- Mortality risk was substantially higher in patients with both conditions
Mortality by which disease was diagnosed first
- no significant difference in mortality risk, aHR
- 0.95
- 95% CI
- 0.85-1.07
Original publication
Development of atrial fibrillation in patients with heart failure and vice versa: incidence, risk factors, and their impact on survival. ESC Heart Fail. Published 28 May 2026. doi:10.1093/eschf/xvag152
Summarised from the published abstract; every number is checked against it