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• Posted November 20, 2024

A-fib Plus Heart Failure a Dangerous Combo

For the 4 in 10 patients with newly diagnosed heart failure who also have the heart rhythm disorder atrial fibrillation, the prognosis can be poor.

"Atrial fibrillation can make heart failure much more problematic, and more complex to treat," said researcher Heidi May, a cardiovascular epidemiologist at Intermountain Health in Salt Lake City. 

That's why she and colleagues who have studied patients with both conditions are urging doctors to screen newly diagnosed heart failure patients for atrial fibrillation (A-fib).

The recommendation is an outgrowth of their new study, which looked at health records of nearly 22,000 patients treated for new-onset heart failure at Intermountain Healthcare between 2009 and 2019.

They presented their findings Monday at an American Heart Association meeting in Chicago. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

This new study not only looked at the prognosis for patients newly diagnosed with heart failure, but also at the type of heart failure they have.

Patients with A-fib and with a type of heart failure in which the heart no longer pumps efficiently have a particularly poor prognosis.

A-fib causes the heart to beat irregularly and often very fast. It's caused by a defect in the heart's electrical system that causes many impulses to fire rapidly at the same time, rather than in a steady, regular pattern.

Though it was known to exist alongside heart failure, little was known about the effect of a dual diagnosis, researchers explained in background notes.

They looked carefully at what is known as ejection fraction, a measurement of how the heart's lower left chamber is pumping blood. To be included in the study, patients had to have that measurement done within 30 days of being diagnosed with heart failure.

In all, more than 7,900 patients had an ejection fraction under 40% (HFrEF) and close to 14,000 had an ejection fraction over 40% (HFpEF). Those patients were more often older (74 versus 65 years of age) and female (53.7% versus 33.1%).

In all, 40% of the newly diagnosed heart failure patients had A-fib. 

Compared to those without A-fib, patients with A-fib were more likely to be hospitalized for subsequent heart failure. They were also more likely to die prematurely. 

May said the findings underscore the need for doctors to make sure that patients with heart failure are screened for A-fib. 

Doctors should be "extra diligent," she said, "because patients with both may require a more aggressive treatment regimen to preserve their quality of life."

Researchers said they plan to conduct a clinical trial to find out the best ways to treat patients who have both conditions.

More information

The Mayo Clinic has more about the causes and symptoms of heart failure.

SOURCE: Intermountain Healthcare, news release, Nov. 18, 2024