Atrial fibrillation (AF) is a common arrhythmia in aging populations and is strongly associated with an increased risk of heart failure (HF) and adverse cardiovascular outcomes. However, early detection of HF among patients with AF remain inadequate in rural settings. This study aims to screen for HF among older adults with AF in rural China and to conduct long-term follow-up in order to observe the disease progression in patients with AF.

This study will recruit at least 2,500 elderly individuals aged between 65 and 80 years, with confirmed diagnoses of AF, residing in rural areas. Participants will undergo HF screening using NT-proBNP testing and echocardiographic assessment. Additionally, data will be collected on electrocardiographic signals, seismocardiography, voice, and demographic characteristics. Following data collection, participants will be followed up every three months to monitor the incidence and progression of HF as well as the occurrence of adverse cardiovascular events.

Inclusion Criteria:

1. Permanent residents with local household registration in rural China.
2. Aged 65-80 years.
3. Electrocardiogram confirmation of AF or possession of a diagnostic certificate for AF issued by a specialist.
4. Willing to participate in HF screening.
5. Ability to understand the study procedures and provide written informed consent.

Exclusion Criteria:

1. Expected life expectancy of less than 3 months.
2. Severe renal insufficiency (Ccr < 30ml/min) or ongoing dialysis treatment.
3. Cardiac insufficiency secondary to correctable causes, including hyperthyroid heart disease, anemic heart disease, or uncorrected congenital heart disease.
4. Indications for pacemaker implantation without having undergone implantation.
5. Chronic obstructive pulmonary disease complicated by type II respiratory failure.
6. Special populations, including patients with mental illnesses.

The study population is rural-dwelling older adults aged 65 to 80 years with confirmed atrial fibrillation in China. Participants are required to undergo heart failure screening and provide informed consent. Individuals with severe comorbidities or conditions that may interfere with study participation will be excluded.

De-identified individual participant data (IPD), including baseline characteristics, laboratory results, echocardiographic data, and follow-up outcomes, will be made available upon reasonable request. Data sharing will be subject to approval by the study investigators and in accordance with institutional policies and ethical regulations.