Wearable Device-Assisted Remote Management to Improve Prognosis in Patients With Acute Heart Failure Complicated by Atrial Fibrillation: WARM-HF Trial (Stage 2)

Inclusion Criteria:

1. Age ≥ 18 years;
2. Subjects diagnosed with acute decompensated heart failure (ADHF) :

1)Heart failure with reduced ejection fraction (HFrEF), defined as left ventricular ejection fraction (LVEF) ≤ 40%; 2)New York Heart Association (NYHA) functional class II-IV; 3)NT-proBNP > 2500 pg/mL or BNP > 600 pg/mL 3. Atrial fibrillation (AF) diagnosed during hospitalization (documented AF episode lasting > 30 seconds on electrocardiogram [ECG] within the past 12 months)

Exclusion Criteria:

1. Intolerance to heart failure pharmacotherapy;
2. Severe anemia or untreated thyroid disease;
3. ST-segment elevation myocardial infarction within 3 months;
4. Known complex congenital heart disease; infiltrative cardiomyopathy (such as cardiac amyloidosis, sarcoidosis, lymphoma, or endomyocardial fibrosis); myocarditis; constrictive pericarditis; cardiac tamponade; hypertrophic cardiomyopathy; stress cardiomyopathy; or uncorrected primary valvular heart disease requiring surgical interventions;
5. Prior major cardiac surgery or mechanical circulatory support, or planned within 6 months, including coronary artery bypass grafting, cardiac valve repair or replacement, ventricular assist device or mechanical circulatory support device implantation, and heart transplantation;
6. Existing pacemaker or planned pacemaker implantation;
7. Contraindications to wearing a smartwatch (such as limb disability or known allergy to rubber/metal materials);
8. Inability to access the Internet or lack of proficiency in operating smart devices.