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Heart failure (HF) increases risk for cognitive impairment in part due to the negative effects of cardiac dysfunction on cerebral perfusion. Atrial fibrillation (AF), an independent risk factor for cognitive impairment, often accompanies HF and is associated with lower systemic perfusion. However, no study has examined the associations among AF, cognitive function, and cerebral perfusion in patients with HF.

A total of 187 HF patients completed neuropsychological testing and underwent transcranial Doppler ultrasonography. Cerebral blood flow velocity of the middle cerebral artery (CBF‐V) operationalized cerebral perfusion. A medical chart review ascertained AF.

History of AF was found in 32.1% of HF patients. HF patients with AF exhibited worse global cognition, memory, and CBF‐V relative to patients without AF. These effects remained after HF severity and other demographic and …