Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and has unfavorable consequences such as stroke, heart failure (HF), and death. HF is the most common adverse event following AF and the leading cause of death. Therefore, identifying the association between AF and HF is important to establish risk stratification for HF in AF. Recent studies suggested that left atrial and ventricular fibrosis is an important link between AF and HF, and the prognostic impact may differ with respect to HF subtype, stratified with left ventricular ejection fraction (EF). Mortality risk in patients with concurrent AF and HF with reduced EF (HFrEF) appears slightly higher compared with those with concurrent AF and HF with preserved EF (HFpEF). On the other hand, the prognostic impact of HF in AF is similar between HFrEF and HFpEF. Further, left atrial size, as well as left atrial and left ventricular functional assessment, are reported to be useful for the prediction of HF in AF, incremental to the conventional risk factors. In this review, we focus on the epidemiological, pathophysiological, and prognostic associations between AF and HF, and review the clinical and echocardiographic predictors for HF in AF.

心房纤颤（AF）是成年人中最常见的持续性心律失常，并具有不良后果，例如中风，心力衰竭（HF）和死亡。HF是继AF后最常见的不良事件，也是主要的死亡原因。因此，确定房颤与心房颤动之间的联系对于建立房颤心房颤动的危险分层很重要。最近的研究表明，左房和心室纤维化是房颤和房颤之间的重要联系，对于以左心室射血分数（EF）分层的房颤亚型，其预后影响可能不同。并发AF和HF并发EF降低（HFrEF）的患者的死亡率风险似乎比并发AF和EF并发EF保留的HF（HFpEF）的患者更高。另一方面，HF对AF的预后影响在HFrEF和HFpEF之间相似。进一步，据报道，左心房大小以及左心房和左心室功能评估可用于预测房颤的心衰，这是常规危险因素的增量。在这篇综述中，我们着重于房颤和心衰之间的流行病学，病理生理学和预后关联，并回顾了房颤中心衰的临床和超声心动图预测指标。