Heart failure (HF) and atrial fibrillation (AF) often coexist, being
closely interrelated as the one increases the prevalence and incidence
and worsens the prognosis of the other. Their frequent coexistence
raises several challenges, including under-diagnosis of HF with
preserved ejection fraction in AF and of AF in HF, characterization and
diagnosis of atrial cardiomyopathy, target and impact of rate control
therapy on outcomes, optimal rhythm control strategy in the era of
catheter ablation, HF-related thromboembolic risk and management of
anticoagulation in patients with comorbidities, such as chronic kidney
disease or transient renal function worsening, coronary artery disease
or acute coronary syndromes, valvular or structural heart disease
interventions and cancer. In the present document, derived by an expert
panel meeting, we sought to focus on the above challenging issues,
outlining the existing evidence and identifying gaps in knowledge that
need to be addressed.