When compared with consecutive beats, our study showed no compromise in the correlation with NT-proBNP, a useful prognostic marker for both heart failure and coronary disease.28 However, this is clearly a limited analysis, and as the weak correlations between LVEF and NT-proBNP show, natriuretic peptide levels can be influenced by a variety of factors, including AF itself.29 When measured on an-index beat, LVEF was higher, on average, than using consecutive beats, and we also demonstrated that the index-beat led to reclassification of LVEF (online supplemental table 6). Here, NPPB is linked to heart failure.