Atrial Fibrillation in Heart Failure

In 1920 Sir James Mackenzie reported that atrial fibrillation was present in 80 to 90 percent of patients who had congestive heart failure, which at that time was called “dropsy.”1 In patients with symptomatic heart failure today, the prevalence of atrial fibrillation ranges from 10 to 30 percent, with the highest incidence among those with the most severe heart failure.2,3 Although there are conflicting data as to whether atrial fibrillation is associated with an adverse outcome,24 this perception has long been common. A recent analysis revealed that the mortality rate was 34 percent higher among patients with atrial . . .