Role of catheter ablation in patients with heart failure and atrial fibrillation
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Atrial fibrillation (AF) and heart failure (HF) frequently coexist with other cardiovascular conditions and adversely affect each other. Over the past few decades, there have been therapeutic advances in AF and HF; however, whether rate-control or rhythm-control is the superior approach for these patients remains controversial. Additionally, there is debate regarding whether antiarrhythmic drug therapy or ablation is the optimal strategy for rhythm-control. The outcomes of AF ablation have improved, and several studies have assessed the potential benefits of AF ablation in patients with HF. The positive impact of catheter ablation in patients with AF and impaired left ventricular (LV) systolic function extends beyond rhythmic outcomes and may result in LV function improvement. This review provides a brief overview of this topic and summarizes several prospective randomized trials that have shown important clinical outcomes comparing AF ablation and non-ablation treatment options in patients with AF and HF so as to provide improved treatment guidance.
Abstract
Atrial fibrillation (AF) and heart failure (HF) frequently coexist with other cardiovascular conditions and adversely affect each other. Over the past few decades, there have been therapeutic advances in AF and HF; however, whether rate-control or rhythm-control is the superior approach for these patients remains controversial. Additionally, there is debate regarding whether antiarrhythmic drug therapy or ablation is the optimal strategy for rhythm-control. The outcomes of AF ablation have improved, and several studies have assessed the potential benefits of AF ablation in patients with HF. The positive impact of catheter ablation in patients with AF and impaired left ventricular (LV) systolic function extends beyond rhythmic outcomes and may result in LV function improvement. This review provides a brief overview of this topic and summarizes several prospective randomized trials that have shown important clinical outcomes comparing AF ablation and non-ablation treatment options in patients with AF and HF so as to provide improved treatment guidance.