Atrial fibrillation, as the most common clinical arrhythmia, is frequently associated with a wide range of comorbidities and polypharmacy, which poses significant challenges in its management. This study was designed to determine the prevalence of comorbidities and medication use patterns among patients with atrial fibrillation hospitalized in an educational hospital in Iran. This descriptive-analytical cross-sectional study was conducted on 90 patients with atrial fibrillation admitted to the cardiac unit of an educational hospital affiliated with Lorestan University of Medical Sciences in 2025. Patients were recruited through consecutive sampling. Data were collected using a demographic and clinical questionnaire and the Charlson Comorbidity Index (CCI). Data were analyzed using descriptive statistics. The most prevalent comorbidities were hypertension (74.4%), heart failure (47.8%), diabetes mellitus (42.2%), and a history of myocardial infarction (28.9%), respectively. Regarding pharmacological treatment, 96.7% of patients received anticoagulant therapy, more than 90% were prescribed beta-blockers, and 55.6% received angiotensin receptor blockers (ARBs). Calcium channel blockers had the lowest frequency of use (12.2%). Furthermore, 61.1% of patients were taking five or more medications simultaneously, indicating a considerable burden of polypharmacy in this population. In conclusion, Hospitalized patients with atrial fibrillation in the studied center experience a substantial burden of cardiometabolic multimorbidity and polypharmacy, requiring a multidimensional approach beyond arrhythmia control alone. These findings highlight the necessity of developing person-centered and team-based care programs emphasizing integrated disease management, rational medication regimen optimization, and patient empowermen