Atrial fibrillation and heart failure with preserved ejection fraction: diagnostic challenges and therapeutic opportunities. [Review]

Verelst, F.; Witte, KK.; Ahmed, FZ.; Al-Khatib, SM.; Parkash, R.; Gevaert, AB.; Van Spall, HGC.

Atrial fibrillation and heart failure with preserved ejection fraction: diagnostic challenges and therapeutic opportunities. [Review]

All Authors

Verelst, F.

Witte, KK.

Ahmed, FZ.

Al-Khatib, SM.

Parkash, R.

Gevaert, AB.

Van Spall, HGC.

LTHT Author

Witte, Klaus

LTHT Department

Cardio-Respiratory
Cardiology

Publication Date

2026

Item Type

Journal Article
Review

Subject

ATRIAL FIBRILLATION , CATHETER ABLATION , HEART FAILURE , PACEMAKER, ARTIFICIAL , PHARMACOLOGY, CLINICAL

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a syndrome characterised by cardiac and non-cardiac physiologic disturbances, commonly underpinned by cardiometabolic abnormalities, which culminate in elevated left ventricular filling pressures and progressive symptoms of exercise intolerance. Arrhythmias, particularly atrial fibrillation (AF), are common in HFpEF and have important clinical implications. AF complicates the diagnosis and management of HFpEF. In this review, we synthesise the impact of AF on disease detection, symptom burden and prognosis and HFpEF treatment. Furthermore, we review pharmacological and interventional therapies that may mitigate the risk of AF and improve how patients with HFpEF feel, function and survive.