Key result
Incident atrial fibrillation was not associated with decreased survival in a population with advanced heart failure, suggesting prevention strategies may not benefit survival in this group.
Why the study?
Does incident atrial fibrillation worsen prognosis in patients with congestive heart failure?
Does incident atrial fibrillation worsen prognosis in patients with congestive heart failure?
The prognostic impact of incident atrial fibrillation in heart failure may depend on the severity of the underlying heart failure, suggesting that preventing AF in advanced HF may not yield survival benefits.
In a recent issue of Circulation, Wang et al 1 report that incident atrial fibrillation in patients with congestive heart failure carries a poor prognosis. They rightfully argue that early intervention to prevent atrial fibrillation in heart failure patients and to prevent congestive heart failure in patients with atrial fibrillation may importantly improve prognosis in patients suffering from one of these conditions. Previously, in a population with advanced heart failure, we did not find a decreased survival associated with incident atrial fibrillation. 2 This suggests that if patients suffer from advanced heart failure without previous atrial fibrillation, strategies aiming at prevention of the arrhythmia may not benefit any survival.
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Folkeringa et al. (2004) conducted a letter in Congestive heart failure and atrial fibrillation. Incident atrial fibrillation vs. No incident atrial fibrillation was evaluated on Survival. Incident atrial fibrillation was not associated with decreased survival in a population with advanced heart failure, suggesting prevention strategies may not benefit survival in this group.
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