〔Abstract〕 Objective To investigate the effects of rivaroxaban on left ventricular function and myocardial ischemia markers in elderly patients with stable coronary heart disease (CHD) complicated with atrial fibrillation (AF). Methods 74 elderly patients with stable CHD complicated with AF admitted to Anyang Third People's Hospital from June 2019 to August 2020 were randomly divided into a control group and an observation group, with 37 cases in each group. The control group received conventional treatment, and the observation group was treated with rivaroxaban on the basis of the control group, and the treatment effect of the two groups were compared. Results After treatment, the end-diastolic left ventricular posterior wall depth (LVPWD), late diastolic peak velocity (A), the levels of myocardial ischemia markers, duration of attack, attack frequency, ST segment depression at the attack in the observation group were lower than those of the control group, early diastolic peak velocity (E) was higher than that of the control group, the differences were statistical significance (P < 0.05). The incidence of adverse reactions in the observation group was 5.41% lower than 21.62% in the control group, and the difference was statistically significant (P < 0.05). Conclusion Rivaroxaban has a better effect on elderly patients with stable CHD with AF, which can effectively shorten the duration of attack and improve the level of myocardial ischemia markers