Abstract: AIM To investigate the effect of serum uric acid (SUA) levels on atrial fibrillation (AF) in patients with ischemic heart failure (HF). METHODS A total of 363 consecutive patients with ischemic HF enrolled in our hospital were divided into two groups: AF group and non-AF group. We examined the baseline characteristics between groups and evaluated the relationship between SUA and AF by multivariate logistic regression analysis. RESULTS AF occurred in 21.5% (78/363) patients and 78.5% (285/363) patients had normal sinus rhythm. SUA levels in AF patients were significantly increased compared with those in normal sinus rhythm patients ［(6.4±2.09) vs.(5.7±1.9) mg/dl, P<0.001］. Age in AF patients was significantly higher than in normal sinus rhythm patients ［(71±8) vs.(66±11) mg/dl, P<0.01］. Echocardiographic parameters including ejection fraction, left atrial diameter, left ventricle end-diastolic diameter and left ventricle end-diastolic volume in AF patients were also significantly higher than those in normal sinus rhythm patients. Multivariate analysis showed that SUA was an independent risk factor of AF in patients with ischemic HF (OR=1.27, 95% CI, 1.06-1.52, P=0.010). CONCLUSION SUA level is significantly higher in AF patients and is independently associated with AF in patients with ischemic HF.