Dr. Chu Huimin: I am Chu Huimin from the Cardiac Arrhythmia Treatment Center of Ningbo First Hospital. Our lecture today focuses on the relationship between heart failure and atrial fibrillation, the treatment of patients with atrial fibrillation combined with heart failure and the outcome after treatment, and how to enable patients to improve their quality of life. What is heart failure? Dr. Huimin Chu: Heart failure is also the failure of heart function. Just like a car has an engine, the heart is the human engine. If the contraction of the heart is weakened, then it indicates that the heart is failing. Once the contraction of the heart is weakened, it will lead to insufficient blood supply to the organs of the body, such as the liver, kidneys, cerebrovascular and other organs to fail. Heart failure can have a great impact on the patient’s daily life, and it also reduces the survival rate and shortens the survival time. What causes heart failure? Dr. Huimin Chu: There are many causes of heart failure. For example, heart failure caused by cardiomyopathy, which includes ischemic cardiomyopathy, hypertrophic cardiomyopathy, dilated cardiomyopathy, and so on. Any disease that causes a decrease in the contractility of the heart muscle and factors that cause a decrease in heart function are causes of heart failure. What is the relationship between atrial fibrillation and heart failure? Dr. Huimin Chu: When atrial fibrillation occurs, the patient’s heart will beat irregularly, and the speed of the beat is not controlled by the “command” – the sinus node. When the atria beat rapidly and irregularly, it will lead to the loss of its normal systolic and diastolic functions; in addition, when the abnormal beating of the atria is irregularly transmitted to the ventricles, it will lead to irregular contraction of the ventricles. Once heart failure patients develop atrial fibrillation, it leads to a progressive decline in cardiac function and suggests a poorer prognosis. Atrial fibrillation promotes further deterioration of heart failure, and heart failure promotes the development and maintenance of atrial fibrillation. What are the chances of atrial fibrillation progressing to heart failure? Dr. Huimin Chu: The chances of developing atrial fibrillation to heart failure are high. It is not true that all patients with atrial fibrillation will develop heart failure, but about 50% of patients will have a combination of different degrees of cardiac insufficiency. What are the risks of atrial fibrillation combined with heart failure? Dr. Huimin Chu: Atrial fibrillation can worsen the progression and deterioration of heart failure. There are several cases of atrial fibrillation combined with heart failure: a. Patients who had atrial fibrillation and then progressed to heart failure. In patients with atrial fibrillation, 1/3 to 1/2 of them will progress to heart failure. Second, the combination of atrial fibrillation on top of heart failure. A part of patients suffering from heart failure based on, for example, their own ischemic diseases (such as myocardial infarction); if combined with atrial fibrillation, then the progression of heart failure will be faster and the patient’s physical condition will go directly downhill, increasing the readmission rate. In addition, heart failure combined with atrial fibrillation also increases the risk of cardiogenic stroke due to atrial fibrillation.