In patients with AF, with or without HF, lower heart rate, however, is not associated with a better outcome as was shown recently . Although patients with AF were included in the large HF trials, the absolute number of patients with AF in each individual study was limited. The aim of the present meta-analysis therefore was to assess the effect of beta-blockade on outcome (i.e., mortality and hospitalization for HF) in patients with both HF and AF.