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Lower heart rates are associated with better outcomes in patients with heart failure in sinus rhythm (SR). Is the same true for heart failure patients in atrial fibrillation (AF)? Between 1999 and 2010, investigators in the U.K. assessed 2039 patients with heart failure and left ventricle ejection fractions of ≤50%, 24% of whom were in AF at baseline. Of these, 841 were restudied after 1 year of treatment optimization; 22% were in AF. Mortality for all patients was assessed in 2011.
After median follow-up of 3.6 years, overall survival was shorter for patients in AF than for those in SR, but the difference was no longer significant after adjustment for other important clinical factors (e.g., age, sex, diabetes, heart failure class, medicatio…