Evidence based practice in patients with combined atrial fibrillation and heart failure

---was very low in the Euro Heart Survey on Atrial Fibrillation:

…29% received the recommended drug therapy for both LVSD-HF and AF, consisting of the combination of a beta-blocker, either ACEI or angiotensin II receptor blocker, and oral anticoagulation. Rate control was insufficient with 40% of all HF patients with permanent AF having a heart rate of 80 beats/min.

The latter finding is particularly disturbing, since aggressive rate or rhythm control of atrial fibrillation is associated with improvement in ejection fraction.