{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:47:08Z","timestamp":1785768428077,"version":"3.56.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":487,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20220680"],"award-info":[{"award-number":["20220680"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20220680"],"award-info":[{"award-number":["20220680"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Heart failure (HF) and atrial fibrillation (AF) often coexist. We explored AF incidence, prevalence, and treatment strategies in patients with versus without HF across the ejection fraction (EF) spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed patients with HF from the Swedish HF Registry (1 December 2005\u201331 December 2021), matched 1:1 by sex, age, and county of residence to patients without HF from Statistics Sweden. Two study cohorts were derived (i) to assess AF prevalence and treatments, and (ii) to evaluate AF incidence and related predictors. Overall, 195\u2009106 patients were considered, 50% of them with HF (of whom 54% with HF with reduced [HFrEF], 23% mildly reduced [HFmrEF], and 23% with preserved EF [HFpEF]). From 2006 to 2021, AF prevalence increased in both patients with (57% to 58%) and without HF (8% to 11%). HF patients, particularly if with HFrEF, were more likely receiving AF treatments than those without HF. Over time, antiarrhythmic use decreased, while rate control drugs and oral anticoagulant use, and AF-related procedures increased, regardless of HF and EF. During a median follow-up of 3.7\u2009years, in 86\u2009210 patients without AF, incident AF risk was two-fold higher in HF versus non-HF (hazard ratio [HR] 2.76, 95% confidence interval [CI] 2.45\u20133.12), highest in HFpEF (HR 3.12, 95% CI 2.65\u20133.67) versus HFrEF (HR 2.68, 95% CI 2.34\u20133.06) and HFmrEF (HR 2.53, 95% CI 2.17\u20132.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Atrial fibrillation prevalence, anticoagulant use, and AF-related procedures increased over time regardless of HF, with HF patients more likely receiving AF treatments. In HF, despite higher AF prevalence and incidence in HFpEF, AF treatment use remained modest, calling for further implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.3402","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T07:33:03Z","timestamp":1722497583000},"page":"236-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Characterizing Atrial Fibrillation in Patients with and Without Heart Failure Across the Ejection Fraction Spectrum: Incidence, Prevalence, and Treatment Strategies"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7858-5550","authenticated-orcid":false,"given":"Valeria","family":"Valente","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Ferrannini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Internal Medicine Unit, S\u00f6dert\u00e4lje Hospital , S\u00f6dert\u00e4lje ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Benson","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gatti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Internal Medicine Unit, S\u00f6dert\u00e4lje Hospital , S\u00f6dert\u00e4lje ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Guidetti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Melin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Division of Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet , Solna ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frieder","family":"Braunschweig","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Heart, Vascular and Neuro Theme, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Linde","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Heart, Vascular and Neuro Theme, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Dahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Department of Health, Medicine and Caring Sciences, Link\u00f6ping University , Link\u00f6ping ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Heart, Vascular and Neuro Theme, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marat","family":"Fudim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Duke University School of Medicine , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7732-0887","authenticated-orcid":false,"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"2026010913030988100_ejhf3402-bib-0001","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1161\/CIRCULATIONAHA.115.018614","article-title":"Atrial fibrillation begets heart failure and vice versa","volume":"133","author":"Santhanakrishnan","year":"2016","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0002","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jchf.2017.05.001","article-title":"Atrial fibrillation in heart failure with preserved, mid-range, and reduced ejection fraction","volume":"5","author":"Sartipy","year":"2017","journal-title":"JACC Heart Fail"},{"key":"2026010913030988100_ejhf3402-bib-0003","doi-asserted-by":"crossref","first-page":"4277","DOI":"10.1093\/eurheartj\/ehy626","article-title":"Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: A report from 14\u2009964 patients in the European Society of Cardiology Heart Failure Long-Term Registry","volume":"39","author":"Zafrir","year":"2018","journal-title":"Eur Heart J"},{"key":"2026010913030988100_ejhf3402-bib-0004","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/ejhf.187","article-title":"The prognostic significance of atrial fibrillation in heart failure with a preserved and reduced left ventricular function: Insights from a meta-analysis","volume":"16","author":"Cheng","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026010913030988100_ejhf3402-bib-0005","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1093\/eurheartj\/eht295","article-title":"Adherence to cardiovascular therapy: A meta-analysis of prevalence and clinical consequences","volume":"34","author":"Chowdhury","year":"2013","journal-title":"Eur Heart J"},{"key":"2026010913030988100_ejhf3402-bib-0006","doi-asserted-by":"crossref","DOI":"10.1093\/ehjopen\/oead051","article-title":"Guideline-directed medical therapies for comorbidities among patients with atrial fibrillation: Results from GARFIELD-AF","volume":"3","author":"Camm","year":"2023","journal-title":"Eur Heart J Open"},{"key":"2026010913030988100_ejhf3402-bib-0007","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"24","author":"McDonagh","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2026010913030988100_ejhf3402-bib-0008","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the management of heart failure: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0009","article-title":"Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: Cohort study based on longitudinal data from the Framingham Heart Study","volume":"361","author":"Staerk","year":"2018","journal-title":"BMJ"},{"key":"2026010913030988100_ejhf3402-bib-0010","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1160\/TH16-11-0825","article-title":"Are cardiovascular risk factors also associated with the incidence of atrial fibrillation? A systematic review and field synopsis of 23 factors in 32 population-based cohorts of 20 million participants","volume":"117","author":"Allan","year":"2017","journal-title":"Thromb Haemost"},{"key":"2026010913030988100_ejhf3402-bib-0011","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1161\/CIRCULATIONAHA.110.009035","article-title":"Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: The Atherosclerosis Risk in Communities (ARIC) study","volume":"123","author":"Huxley","year":"2011","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0012","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC). Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2020","journal-title":"Eur Heart J"},{"key":"2026010913030988100_ejhf3402-bib-0013","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int J Stroke"},{"key":"2026010913030988100_ejhf3402-bib-0014","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0015","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/europace\/eut373","article-title":"A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: Baseline results of EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry","volume":"16","author":"Lip","year":"2014","journal-title":"Europace"},{"key":"2026010913030988100_ejhf3402-bib-0016","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1056\/NEJMoa021328","article-title":"A comparison of rate control and rhythm control in patients with atrial fibrillation","volume":"347","author":"Wyse","year":"2002","journal-title":"N Engl J Med"},{"key":"2026010913030988100_ejhf3402-bib-0017","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early rhythm-control therapy in patients with atrial fibrillation","volume":"383","author":"Kirchhof","year":"2020","journal-title":"N Engl J Med"},{"key":"2026010913030988100_ejhf3402-bib-0018","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1056\/NEJMoa1707855","article-title":"Catheter ablation for atrial fibrillation with heart failure","volume":"378","author":"Marrouche","year":"2018","journal-title":"N Engl J Med"},{"key":"2026010913030988100_ejhf3402-bib-0019","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1056\/NEJMoa2306037","article-title":"Catheter ablation in end-stage heart failure with atrial fibrillation","volume":"389","author":"Sohns","year":"2023","journal-title":"N Engl J Med"},{"key":"2026010913030988100_ejhf3402-bib-0020","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1161\/CIRCULATIONAHA.121.057095","article-title":"Randomized ablation-based rhythm-control versus rate-control trial in patients with heart failure and atrial fibrillation: Results from the RAFT-AF trial","volume":"145","author":"Parkash","year":"2022","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0021","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"26","author":"Tzeis","year":"2024","journal-title":"Europace"},{"key":"2026010913030988100_ejhf3402-bib-0022","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1093\/eurheartj\/ehs348","article-title":"Increased mortality among patients taking digoxin-analysis from the AFFIRM study","volume":"34","author":"Whitbeck","year":"2013","journal-title":"Eur Heart J"},{"key":"2026010913030988100_ejhf3402-bib-0023","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.121.023907","article-title":"Global oral anticoagulation use varies by region in patients with recent diagnosis of atrial fibrillation: The GLORIA-AF phase III registry","volume":"11","author":"Bayer","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2026010913030988100_ejhf3402-bib-0024","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1056\/NEJMoa2303062","article-title":"Anticoagulation with edoxaban in patients with atrial high-rate episodes","volume":"389","author":"Kirchhof","year":"2023","journal-title":"N Engl J Med"},{"key":"2026010913030988100_ejhf3402-bib-0025","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1056\/NEJMoa2310234","article-title":"Apixaban for stroke prevention in subclinical atrial fibrillation","volume":"390","author":"Healey","year":"2024","journal-title":"N Engl J Med"},{"key":"2026010913030988100_ejhf3402-bib-0026","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1161\/CIRCULATIONAHA.120.050991","article-title":"Ablation versus drug therapy for atrial fibrillation in heart failure","volume":"143","author":"Packer","year":"2021","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0027","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1161\/CIRCULATIONAHA.121.056323","article-title":"Early rhythm control therapy in patients with atrial fibrillation and heart failure","volume":"144","author":"Rillig","year":"2021","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0028","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.1016\/j.jacc.2016.08.048","article-title":"Heart failure with preserved ejection fraction and atrial fibrillation: Vicious twins","volume":"68","author":"Kotecha","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2026010913030988100_ejhf3402-bib-0029","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1161\/CIRCULATIONAHA.113.001475","article-title":"Temporal relationship and prognostic significance of atrial fibrillation in heart failure patients with preserved ejection fraction","volume":"128","author":"Zakeri","year":"2013","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0030","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1016\/j.jacc.2006.01.060","article-title":"Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: Results from the Candesartan in Heart Failure-Assessment of Reduction in Mortality and morbidity (CHARM) program","volume":"47","author":"Olsson","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2026010913030988100_ejhf3402-bib-0031","doi-asserted-by":"crossref","first-page":"6762","DOI":"10.1038\/s41598-020-63878-9","article-title":"Impact of hemoglobin levels and their dynamic changes on the risk of atrial fibrillation: A nationwide population-based study","volume":"10","author":"Lim","year":"2020","journal-title":"Sci Rep"},{"key":"2026010913030988100_ejhf3402-bib-0032","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1161\/CIRCULATIONAHA.111.020982","article-title":"Chronic kidney disease is associated with the incidence of atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC) study","volume":"123","author":"Alonso","year":"2011","journal-title":"Circulation"},{"key":"2026010913030988100_ejhf3402-bib-0033","doi-asserted-by":"crossref","DOI":"10.1177\/03000605211041439","article-title":"Renin-angiotensin system inhibitors and clinical outcomes in patients with atrial fibrillation and heart failure: A propensity score-matched study from the Chinese Atrial Fibrillation Registry","volume":"49","author":"Lin","year":"2021","journal-title":"J Int Med Res"},{"key":"2026010913030988100_ejhf3402-bib-0034","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s10741-022-10281-3","article-title":"Association between sodium-glucose cotransporter-2 inhibitors and incident atrial fibrillation\/atrial flutter in heart failure patients with reduced ejection fraction: A meta-analysis of randomized controlled trials","volume":"28","author":"Sfairopoulos","year":"2023","journal-title":"Heart Fail Rev"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/27\/2\/236\/65347396\/eurjhf_27_2_236.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/27\/2\/236\/65347396\/eurjhf_27_2_236.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T18:03:33Z","timestamp":1767981813000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/27\/2\/236\/8322111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,1]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,8,1]]},"published-print":{"date-parts":[[2025,2,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ejhf.3402","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,8,1]]},"assertion":[{"value":"2024-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}