Patients with atrial fibrillation, common in those with advanced chronic heart failure, have an increased risk of hospitalisation due to heart failure, according to new research from researchers at the University of Alabama at Birmingham (UAB). The findings, published in June in the European Heart Journal, also suggest that atrial fibrillation is not associated with an increased risk of death in heart failure patients, contradicting previous assumptions.
“Our findings show that the presence of atrial fibrillation in heart failure patients did not increase their risk of death, as has been previously suggested, but did increase the risk of hospitalisation due to worsening heart failure,” said Mustafa Ahmed, a physician-scientist at the UAB American Board of Internal Medicine Research Pathway Program and the study’s lead investigator. “Importantly, atrial fibrillation significantly increased hospitalisation due to heart failure only in patients not receiving a beta-blocker or drugs that block the beta-receptors in the heart but not in those receiving a beta-blocker,” said Ali Ahmed, associate professor in the division of gerontology, geriatrics and palliative care medicine, director of UAB’s Geriatric Heart Failure Clinic and the study’s senior investigator. “In patients with heart failure and atrial fibrillation, beta-blockers, which help reduce heart rate, may be useful in reducing the risk of hospitalisation due to worsening heart failure.”
Ahmed and colleagues matched 487 pairs of heart failure patients with and without atrial fibrillation from the Beta-Blocker Evaluation of Survival Trial. All-cause mortality occurred in 38% of the patients with atrial fibrillation against 37% of patients without. However, 44% patients with atrial fibrillation were hospitalised for worsening heart failure over the course of the trial, against only 38% without.
The research was supported through a grant from the National Heart, Lung and Blood Institute, one of the National Institutes of Health, and a generous gift from Ms Jean B Morris of Birmingham, Alabama.
Ahmed’s co-researchers were Mustafa Ahmed, James Ekundayo, Inmaculada Aban, Bo Liu, all from UAB; Michel White, Montreal Heart Institute; Thomas Love, Case Western Reserve University; and Wilbert Aronow, New York Medical College.