Frequency of Atrial Fibrillation in Patients of Heart Failure with Reduced Ejection Fraction

Abstract

Background: A comprehensive review of the literature indicates that there is a dearth of information about AF in heart failure in the local community, with most of the information coming from research conducted internationally, the results of which cannot be generalized due  to demographic and clinical variations. Therefore this study was planned to determine the frequency of atrial fibrillation in patients of heart failure with reduced ejection fraction(HFrEF).

Methodology: This cross sectional study was carried out at the department of cardiology, PIMS hospital, Islamabad from 19 Sep 2025 till 19 March 2026 . A total of 258 male and female patients in the age range 20 to 80 years diagnosed with heart failure with ejection fraction less than 40.0% were enrolled. The patients were evaluated for the presence of atrial fibrillation through clinical examination and ECG findings. Data analysis was carried out using SPSS v. 26.

Results: The mean age of the participants was 48.85±12.16 years. Participants aging more than 50 years were 122 (47.3%) while 214 patients (82.9%) were male. Diabetes mellitus was present in 46 patients (17.8%) while NYHA class IV was recorded in 202 patients (78.3%). Atrial fibrillation was recorded in 29 patients (11.2%). No statistically significant association was recorded between atrial fibrillation and baseline clinico-demographic parameters (p value >0.05).

Conclusion: The frequency of atrial fibrillation in this cohort of HFrEF patients was lower than that reported in global studies, probably due to younger age distribution of the study population. These results highlight the variability in the association between atrial fibrillation and HFrEF and emphasize the importance of regional data for accurate assessment and treatment strategies.

Key words: Atrial Fibrillation, Heart Failure, Reduced Ejection Fraction