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Integrated Care in Patients with Atrial Fibrillation and Optimal Medical Treatment for Heart Failure: Results from

Iwona Gorczyca-Głowacka1, Karolina Molenda2, Maciej Nadel3

  • 1Collegium Medicum, The Jan Kochanowski University, 25-317 Kielce, Poland.

Journal of Clinical Medicine
|December 11, 2025
PubMed

Insights

Integrated treatment for heart failure (HF) and atrial fibrillation (AF) improves prognosis. Optimal medical therapy (OMT) adherence reduced all-cause death, while the Atrial Fibrillation Better Care (ABC) pathway showed no significant benefit alone.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Heart failure (HF) and atrial fibrillation (AF) frequently coexist, significantly impacting patient prognosis.
  • Limited data exists on integrated strategies for managing patients with both HF and AF.
  • This study investigates the interplay between HF subtypes, optimal medical therapy (OMT), and the Atrial Fibrillation Better Care (ABC) pathway in predicting outcomes.

Purpose of the Study:

  • To evaluate the association between HF subtype, OMT adherence, ABC pathway compliance, and all-cause mortality in patients with HF and AF.
  • To assess the effectiveness of integrated treatment strategies in improving prognosis for this patient population.

Main Methods:

  • Prospective, multicenter cohort study (Heart failuRe ObsErvational Study) including 627 hospitalized and outpatient patients with HF and AF.
  • Patients were categorized into three groups: ABC + OMT, noABC + OMT, and noABC + noOMT.
  • Analysis focused on adherence to OMT and the ABC pathway, and their correlation with all-cause death.

Main Results:

  • Optimal medical therapy (OMT) compliance was significantly associated with a reduced risk of all-cause death (HR 0.61, p=0.01).
  • Adherence to the Atrial Fibrillation Better Care (ABC) pathway alone did not show a significant association with reduced mortality (HR 0.74, p=0.12).
  • Patients in the integrated ABC + OMT group had a significantly lower risk of all-cause death compared to the noABC + noOMT group (HR 0.60, p=0.02).

Conclusions:

  • Integrated treatment strategies, combining OMT and ABC pathway adherence, were implemented in approximately half of the studied HF and AF patients.
  • These integrated strategies were associated with a better long-term prognosis compared to less comprehensive treatment approaches.
  • The findings underscore the importance of a combined therapeutic approach for patients with comorbid HF and AF.

Keywords:
atrial fibrillationheart failureintegrated careoptimal medical treatment

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