Introduction: NT pro-BNP represents an important biomarker for the diagnosis and assessment of heart failure’s evolution, but its role in patients with atrial fibrillation is less studied. Purpose: To evaluate NT proBNP value in elderly with atrial fi brillation and heart failure. Methods: We studied 49 elderly patients with atrial fi brillation and heart failure with NYHA functional class II-IV, with a mean age of 72.12 ± 6.78 years, 42.9% being women. Heart failure was defined according to 2012 ESC criteria. NT pro-BNP was determined using ELISA method. Results: The average value of NT pro-BNP was increased: 1639.122 ± 993.03 pg/ml. The following mean values for lipid fractions were registered: total cholesterol 161.30 ± 50.28 mg/dl; LDL-cholesterol 100.79 ± 36.72 mg/dl; triglycerides 129.56 ± 66.37mg/dl; HDL-cholesterol 34.85 ± 10.56 mg/dl. NT pro-BNP directly correlated with age (r = 0.445, p = 0.002) and NYHA class (r = 0.545, p = 0.003). There were also indirect correlations found, but of borderline significance with ejection fraction (r = -0.186), LDL cholesterol (r = -0.268), serum triglycerides (r = -0.136), and total cholesterol (r = -0.249). Conclusions: NT pro-BNP may be a marker of the evolution of heart failure in elderly patients with atrial fi brillation.