Atrial fibrillation (AF) represents the most common sustained cardiac arrhythmia in patients with heart failure (HF). AF in HF patients is associated with worsening of symptoms and also results in a substantial increase in mortality. Although HF patients in sinus rhythm have a better outcome than patients with AF, several randomized studies investigating pharmacological rhythm control versus rate control have shown no advantage of one strategy over the other in terms of patient outcomes. Catheter-based ablation therapy is a newer therapeutic option with a rapidly evolving and changing role in the management of this arrhythmia. In the present review, the authors discuss the epidemiology, pathophysiology and prognostic significance of AF in patients with HF. Exclusively addressed are studies investigating catheter-based ablation for rhythm-control and rate-control therapies in the management of AF in HF patients.
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