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Atrial fibrillation in heart failure with preserved ejection fraction: a risk marker, risk factor or confounder?
  1. Agnieszka Kapłon-Cieślicka1,
  2. Lars H Lund2
  1. 1 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
  2. 2 Unit of Cardiology, Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
  1. Correspondence to Dr Agnieszka Kapłon-Cieślicka, 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; agnieszka.kaplon{at}

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To the Editor

In their recently published article Son et al 1 reported that in patients with acute heart failure (HF), atrial fibrillation (AF) was most prevalent in HF with preserved ejection fraction (EF)—HFpEF—and was a risk factor for long-term mortality only in HFpEF, contrary to in HF with reduced EF (HFrEF) and mid-range EF (HFmrEF). The frequent coexistence of AF and HFpEF may be attributable to two reasons: (1) AF and HFpEF share the same risk factors which result in microvascular inflammation and subsequent myocardial fibrosis promoting the development of both HFpEF and AF (in contrast to HFrEF and HFmrEF, which are triggered by direct damage to the left ventricle, often due …

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  • Contributors AK-C has written the response. LL has revised the response.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.