Randomized Clinical Trials of Catheter Ablation of Atrial Fibrillation in Congestive Heart Failure: Knowns and Unmet Needs.

Atrial fibrillation (AF) and heart failure (HF) are conditions that frequently coexist and are associated with worse outcomes compared with either condition alone. Although rhythm control with antiarrhythmic drug treatment is not superior to rate control in this population, catheter ablation has emerged as an alternative and more effective treatment of maintenance of sinus rhythm. Some trials have shown benefit in hospitalization and mortality, but additional studies are needed. The authors summarize the current evidence regarding catheter ablation outcomes, efficacy, and safety and discuss the unmet needs of the existing and ongoing randomized clinical trials.