Heart Failure, Atrial Fibrillation and Warfarin

Publication Date: 
Sat, 11/01/2014
By: Alere Staff

If you have heart failure or atrial fibrillation, you’re not alone. Heart failure affects 5.1 million Americansand there are between 2.7 and 6.1 million patients with atrial fibrillation.1,2 The reason for the wide range of numbers of patients with atrial fibrillation is that only about 30% of patients with atrial fibrillation have symptoms thus making the condition go widely undiagnosed.

These diseases also have something else in common: Cost.

Together the management of these conditions totals $58 billion per year. Heart failure accounts for $32 billion year to treat while atrial fibrillation draws from the healthcare budget at an annual cost of $26 billion per year.1,2

Since heart failure is affected by environment and lifestyle, it is considered more preventable than atrial fibrillation. Heart failure can be caused by smoking tobacco, eating foods high in fat, cholesterol, and sodium, not getting enough physical activity and obesity.1 Atrial fibrillation (an abnormal rhythm, quivering of the atrium) is far more difficult to predict or determine its cause.

A patient with both heart failure and atrial fibrillation has a higher risk of stroke than a patient with heart failure alone.3A study of mortality at 1 and 3 years in patients treated with warfarin to prevent blood clot development included 195 hospitals (2005-2011) and found that using warfarin to prevent stroke at hospital discharge improved survival at both year 1 and year 3 but hospital readmission remained unchanged.3

The finding suggested that stroke was not a primary cause of readmission for patients taking warfarin with heart failure and atrial fibrillation. Other heart conditions led patients to be readmitted.

Medicare and most commercial insurance providers reimburse patients with atrial fibrillation for up to weekly INR self-testing.4 Weekly self-testing has been shown to improve patient safety and reduce adverse events which commonly result in hospital admission.5



1. 2014. Retrieved October 20, 2014 from web site: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_failure.htm

2. 2014. Retrieved October 20, 2014 from web site: http://circ.ahajournals.org/content/early/2014/04/10/CIR.0000000000000041

3. 2014. Retrieved October 20, 2014 from web site: http://circoutcomes.ahajournals.org/content/7/5/670.full

4. Center for Medicare and Medicaid Services. (2008). Decision Memo for Prothrombin Time (INR) Monitor for Home Anticoagulation Management  (CAG-00087R) [Memorandum]. Baltimore, MD.

5. Am J Manag Care. 2014;20(3):202-209