OBJECTIVES: While kinesiophobia is a recognised phenomenon in global cardiovascular rehabilitation, its prevalence and characteristics remain unexplored in the specific and growing population of patients hospitalised with atrial fibrillation and heart failure (AFHF). This study aims to investigate the prevalence of kinesiophobia and to identify its associated factors among hospitalised AFHF patients in China, thereby contributing to a broader understanding of this barrier to physical activity in a critical patient subgroup worldwide. METHODS: In this cross-sectional study, participants were recruited through convenience sampling from a grade A general hospital in Hangzhou, Zhejiang Province, China. Participants completed questionnaires that included measures of kinesiophobia, self-efficacy, symptoms, depression, anxiety, medical coping strategies, social support, and demographic information. RESULTS: A total of 212 inpatients with AFHF (age: 21-91, mean age: 65.22 ± 10.30 years, 60.4% male) were included in the study, including 128 males (60.4%) and 84 females (39.6%). The findings revealed that a significant majority (71.2%) of patients experienced kinesiophobia (mean score: 40.60 ± 5.771). The results of multiple linear regression (MLR) analysis showed that the main variables associated with kinesiophobia in patients with AFHF were previous hospitalisation for heart disease, New York Heart Association (NYHA) classification, depression,medical coping styles, self-efficacy, and occupation, with six variables together explaining 44.2% of the total variation. CONCLUSION: Kinesiophobia was found to be common in patients with AFHF in China, influenced by various factors. We recommend that early evaluation of kinesiophobia be considered in patients with AFHF.