Table 88: PICO characteristics of review question Population People diagnosed with heart failure in a community or outpatient setting who also have atrial fibrillation Aged under 75 years Aged 75 and over. Interventions Biomarker monitoring: serial (protocol-driven) measurements of circulating biomarker concentration: NT-proBNP (alone) BNP (alone) Troponin (alone) Combination of 2 biomarkers Combination of all 3 biomarkers Imaging monitoring: serial (protocol-driven) cardiac MRI Imaging monitoring: serial (protocol-driven) echocardiography Comparisons Each other Usual care: Clinical monitoring (protocol-driven) Usual care: Clinical monitoring (not protocol-driven) Outcomes CRITICAL Mortality at during study (Time to event) Quality of life at 12 months (Continuous) Unplanned hospitalisation (all-cause) (Count rate) IMPORTANT Adverse events - hypotension (Dichotomous) Adverse events - hyperkalaemia (Dichotomous) Adverse events - renal function (Continuous) Adverse events - bradycardia (Dichotomous) Adverse events - arrhythmic events (Dichotomous) Study design Systematic reviews of RCTs RCTs 8.3.3 Clinical evidence A search was conducted for randomised trials and systematic reviews of randomised trials comparing the effectiveness of monitoring with repeated biomarker measurement (BNP, NT-proBNP or troponin) or repeated cardiac imaging (echocardiography or cardiac MRI), compared to usual care without repeated measurement or imaging, that had a population or subgroup with atrial fibrillation. Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 No relevant studies were identified. 8.3.4 Economic evidence Published literature No previously published economic evidence was identified for this question in the review. See also the health economic study selection flow chart in Appendix D. 8.3.5 Evidence statements Clinical No relevant clinical evidence was identified for inclusion within this review. Economic No economic evaluations were identified. 