Understanding AFib and Heart Failure

How AFib and Heart Failure Are Related

Understanding AFib and Heart FailureUp to 40% of people who have heart failure also have a diagnosis of atrial fibrillation. People with both atrial fibrillation and heart failure have higher mortality rates than people who do not have both diagnoses.

When heart failure is present, the heart is not able to effectively pump the blood throughout the body efficiently. Fluid accumulates in the lungs and other tissues of the body. The heart muscle may weaken, especially if the underlying causes of failure are not reversed or treatable.

Unfortunately, atrial fibrillation lowers the heart’s ability to pump even further. The measurement of the heart’s ability to pump blood is known as an ejection fraction. A high ejection fraction means that the heart is pumping more effectively than if a low ejection fraction is present.

When atrial fibrillation occurs, the electrical impulses in the upper parts of the heart, known as the atria, are disorganized and extremely rapid. The upper part of the heart does not contract well. It interrupts the entire organ’s orderly pattern of filling with blood and pumping it throughout the body. Atrial fibrillation may reduce the heart’s ability to effectively pump blood by 25%.

If heart failure is already present, atrial fibrillation compounds the problem and makes it more severe. Both conditions may increase the heart’s oxygen requirements. The heart has to work harder. If the muscle is already damaged, further injury may occur. People who have heart failure are more likely to develop abnormal heart rhythms, including atrial fibrillation. A vicious cycle may ensue.


Individuals who suffer from heart failure, atrial fibrillation, or both are more likely to experience transient ischemic attacks, TIAs which are also known as mini strokes, and cardiovascular accidents, CVAs, often referred to as strokes.

Study Shows Surprising Relationship

Medicare is a United States government sponsored insurance program which provides coverage for disabled individuals and people over the age of 65. Researchers examined outcomes for patients over the age of 65 who were hospitalized for heart failure. They found that patients who had AFib had a moderately higher risk of readmission to a hospital within 30 days of discharge after treatment for heart failure when compared with individuals who did not have both diagnoses.

The researchers also discovered that some patients who had both diagnoses were more likely to die during the 30-day period after discharge from the hospital. Among people who had a high ejection fraction, the rates of dying increased during the 30-day period, while it did not among individuals who had the more serious disease.

The researchers concluded that the degree of heart failure was not a reliable predictor of outcomes. They stated that better management of AFib needs to be emphasized when treating patients who have heart failure and atrial fibrillation.

Next page: stroke risk and other conditions associated with heart failure.

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