Objective:To explore the clinical efficacy of dapagliflozin combined with metoprolol extended-release tablet treatment of senile chronic heart failure(CHF)with atrial fibrillation(AF)and influence on patients with myocardial damage.Methods:122 elderly patients with CHF and AF were divided into combined group and control group according to different treatment methods,with 61cases in each group.The control group was treated with metoprolol sustained release tablets,and the combined group was treated with daglizin in addition to the control group.Both groups were treated for 3 months.The efficacy and safety,myocardial injury and cardiac function indexes before and after treatment were observed.Results:The total effective rate in the combined group was higher than that in the control group(95.08%vs.81.97%,P＜0.05).After treatment,the levels of cTnI and NT-proBNP in both groups decreased com-pared to before treatment(P＜0.05),and combined group was lower than the control group(P＜0.05).Thelevelsof LVESD,LVEDD in both groups decreased compared to before treatment(P＜0.05),and combined group was lower than the control group(P＜0.05),LVEF increased compared to before treatment(P＜0.05),and the combined group was higher than the control group(P＜0.05).There was no statistically significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Con-clusion:Dapagliflozin combined with metoprolol extended-release tablet has difinite therapeutic effect on elderly CHF patients with AF,which is beneficial for reducing myocardial injury,improving heart function,and has good security.