There is no drug of choice for atrial fibrillation combined with heart failure because the treatment of atrial fibrillation combined with heart failure requires comprehensive therapy and no single drug can provide good control in patients with atrial fibrillation combined with heart failure. Atrial fibrillation combined with heart failure requires aggressive control of the ventricular rate of atrial fibrillation and enhancement of myocardial contractility, for which digitalis drugs are preferred. In addition to ventricular rate control, drugs that reduce cardiac load, such as diuretics, and drugs that inhibit myocardial remodeling to improve prognosis, such as ACEI or ARB, as well as beta-blockers and aldosterone receptor antagonists, should be given. Drugs to treat the causes of atrial fibrillation and heart failure should also be given, such as secondary prevention therapy for coronary artery disease and antihypertensive drugs for hypertension in patients with coronary artery disease.