Heart failure and atrial fibrillation often go hand in hand
Heart failure and atrial fibrillation (AF) often go hand in hand—and each condition can make the other worse. In fact, heart failure is one of the main risk factors for developing AF. At the same time, AF can also lead to heart failure by making the heart beat irregularly and less efficiently.
When both conditions occur together, the outlook can be more serious. That’s why it’s important to manage them carefully to avoid further complications.
Although heart failure can’t be cured, it can be treated effectively—especially if it’s diagnosed early. Treatment usually includes a combination of:
- Medication to support heart function and manage symptoms
- Lifestyle changes, such as eating a heart-healthy diet and staying active
- Managing other conditions, like diabetes or high blood pressure, which can make heart failure worse
- If you have both heart failure and atrial fibrillation, your risk of having a stroke is higher. You may also notice that your symptoms—like tiredness or breathlessness—get worse, and your quality of life may be affected.
That’s why it’s essential to take your prescribed medication regularly, attend follow-up appointments, and speak to your healthcare team if anything changes. With the right care, many people with heart failure and AF can live well and stay active.
Existing heart failure and atrial fibrillation influence each other
When you have heart failure, the heart muscle can become stretched or damaged over time. This can happen due to scarring, inflammation, or long-term strain on the heart. These changes can affect the upper chambers of the heart (the atria), making it more likely for an irregular heart rhythm called atrial fibrillation (AF) to develop.
If you already have heart failure and then develop AF, it can make your condition worse. The heart may not pump as efficiently, and your risk of complications—like a stroke—can increase.
That’s why it’s so important to treat heart failure early and manage its underlying causes. Depending on how severe your heart failure is, your doctor may prescribe medications such as:
- Beta-blockers
- ACE inhibitors
- Angiotensin receptor blockers (ARBs)
- Aldosterone antagonists (also called mineralocorticoid receptor antagonists)
These medicines help reduce strain on the heart and may lower the risk of developing AF.
It’s also a good idea to have your heart rate and rhythm checked regularly by your GP or heart specialist. Early detection and treatment of AF can help prevent further complications and improve your quality of life.
Untreated atrial fibrillation can be the cause of heart failure
When you have atrial fibrillation (AF), your heart beats irregularly and often too fast. This puts extra strain on the heart muscle, which can make it less efficient over time. If left untreated, AF can lead to or worsen heart failure.
That’s why it’s important to manage your heart rhythm or heart rate. There are two main approaches:
- Rhythm control: trying to restore a normal heartbeat
- Rate control: slowing the heart rate to reduce strain on the heart
- In many cases, rate control with medication is the preferred option. It’s often safer and more effective in the long term, especially if rhythm control hasn’t worked or isn’t suitable. Medicines like beta-blockers or calcium channel blockers are commonly used.
If rhythm control is needed, it may involve:
- Cardioversion – a procedure that uses electricity or medication to reset the heart’s rhythm
- Catheter ablation – a treatment that targets the areas of the heart causing the irregular rhythm
- People with AF are also at higher risk of stroke, so anticoagulant medication (blood thinners) is usually recommended to reduce this risk.
Your doctor will help decide the best treatment plan based on your symptoms, heart function, and overall health. Regular check-ups are important to make sure your treatment is working and to adjust it if needed.
What can you do?
A diagnosis of heart failure brings with it a number of changes. Or at least it should. Because a "lifestyle change", i.e. a change or improvement in living conditions, can already contribute a great deal to an improved quality of life. First and foremost, this includes avoiding stress, which has been shown to have a negative impact on heart health. Furthermore, alcohol consumption should be kept to a minimum and cigarettes should be avoided completely. It is also helpful to exercise regularly, for example as part of a cardiac sports group. It is also important that you take all medications prescribed by your doctor as recommended, as this is the only way they can have an optimal effect.
- References
- www2.hse.ie/conditions/coronary-heart-disease-chd/
- www.hse.ie/eng/about/who/healthwellbeing/selfmanagement/resources-for-people-living-with-a-long-term-health-condition/heart-conditions/
- www.nice.org.uk/guidance/ng106/resources/chronic-heart-failure-in-adults-diagnosis-and-management-pdf-66141541311685
- www.nice.org.uk/guidance/ng196/informationforpublic
9-UK-5-16510-01 08-2025