The BNP is somewhat elevated, but actually at that level it does not indicate significant heart failure. People with real heart failure frequently have BNPs in the thousands. Your BNP of 269 indicates some mild strain on the heart, presumably from atrial fibrillation with a fast pulse rate, but nothing surprising or concerning. I recommend continuing our current treatment aimed at lowering atrial fibrillation rate and trying to convert you back to normal sinus rhythm with a cardioversion procedure.
Macduff Sheehy, M.D.