Heart Failure from Atrial Fibrillation

Heart failure can result from atrial fibrillation overworking the heart. The erratic electrical impulses that cause afib make the heart work harder and can lead to heart failure. This can result from being left in afib for too long, especially with a high heart rate.

The heart becomes enlarged, ineffective, and weak, causing it to be unable to pump oxygenated blood throughout the body. Simply put, afib wears out your heart.

Symptoms of heart failure can include weakness, fatigue, and shortness of breath, which is not unlike normal symptoms of afib. Thus, you may not know that you have heart failure. Your doctor can confirm it with a simple test such as an echocardiogram.


When you’re in afib, heart rate medications are used to control the heart rate to avoid developing heart failure.

Once you develop heart failure, some medications can relieve the heart failure symptoms and, possibly, slow its progression. However, medications may not be able to reverse it.

The heart failure caused by afib can be dramatically improved, effectively reversing it, by having a procedure and getting out of afib. Studies in those with afib and heart failure have shown that both catheter ablation and surgery can yield dramatic results in improving heart failure.

The CASTLE-AF study1 showed that catheter ablation in those with afib and heart failure significantly lowered hospitalizations and deaths compared to those who were treated with medications. Likewise, the CABANA study2 showed that in those with afib and heart failure, catheter ablation reduced deaths by 43% and improved quality of life over those treated with medications.

Surgical procedures for afib have yielded similar results. Restoring normal sinus rhythm through a Cox maze IV surgical procedure, when done in the right afib patients with heart failure, effectively reverses heart failure.3  Similar results have been seen in minimally invasive surgical procedures as well.4

It should be noted that this only applies to those whose heart failure was caused by afib.

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To learn about other reasons that afib can be a problem, see these detailed pages:

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