In the community-based study referenced in the 2 previous Figures, the conclusion is that a large proportion of patients diagnosed with first AFib subsequently developed CHF over 2 decades.[131]  Furthermore, during the period 1980 to 2000, there were no detectable changes in the incidence of CHF, or in mortality risk after development of CHF, in patients diagnosed with first AFib, despite reductions in overall CHF mortality resulting from advances in drug treatment, including angiotensin-converting (ACE)-inhibitors, beta-blockers, aldosterone antagonists, etc.  In other words, despite the improvement in the prognosis of CHF demonstrated in randomized trials, there was no improvement in the prognosis of patients with CHF in the cohort with concomitant AFib.  Thus even with optimal evidence-based therapy, the patient with AFib who develops CHF is at serious and increasing risk of higher mortality over time.

French WJ. Am J Med 2013; 126: 00-00.