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Updated: Mar 28, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Comorbidity of atrial fibrillation and heart failure
Liang-Han Ling1, Peter M Kistler1, Jonathan M Kalman2
1Department of Cardiovascular Medicine, University of Melbourne and The Alfred Hospital, Royal Parade, Melbourne, Victoria 3181, Australia.
Insights
Atrial fibrillation (AF) and heart failure (HF) are growing epidemics. Catheter ablation to restore sinus rhythm shows promise for improving HF symptoms and heart function.
Area of Science:
- Cardiology
- Epidemiology
Background:
- Atrial fibrillation (AF) and heart failure (HF) represent significant global health challenges with increasing prevalence.
- Understanding the bidirectional relationship between AF and HF is crucial, particularly how AF may cause or worsen HF.
Purpose of the Study:
- To explore the complex interplay between AF and HF, including AF's potential role in the etiology of HF with preserved ejection fraction.
- To evaluate current treatment strategies for patients with comorbid AF and HF, considering the advancements in catheter ablation.
Main Methods:
- Review of current literature and emerging data on the relationship between AF and HF.
- Analysis of the impact of catheter ablation for rhythm control in patients with both conditions.
Main Results:
- AF may contribute to the development of HF, potentially triggering ventricular fibrosis in HF with preserved ejection fraction.
- Catheter ablation for AF demonstrates medium-term success in improving HF symptoms, functional capacity, and left ventricular function.
Conclusions:
- The relationship between AF and HF is complex and requires further investigation, especially regarding AF's role in HF etiology.
- Catheter ablation is a viable option for rhythm control in AF patients with HF, with ongoing studies assessing long-term outcomes like stroke and mortality.
Abstract:
Atrial fibrillation (AF) and heart failure (HF) are evolving epidemics, together responsible for substantial human suffering and health-care expenditure. Ageing, improved cardiovascular survival, and epidemiological transition form the basis for their increasing global prevalence. Although we now have a clear picture of how HF promotes AF, gaps remain in our knowledge of how AF exacerbates or even causes HF, and how the development of HF affects the outcome of patients with AF. New data regarding HF with preserved ejection fraction and its unique relationship with AF suggest a possible role for AF in its aetiology, possibly as a trigger for ventricular fibrosis. Deciding on optimal treatment strategies for patients with both AF and HF is increasingly difficult, given that results from trials of pharmacological rhythm control are arguably obsolete in the age of catheter ablation. Restoring sinus rhythm by catheter ablation seems successful in the medium term and improves HF symptoms, functional capacity, and left ventricular function. Long-term studies to examine the effect on rates of stroke and death are ongoing. Guidelines continue to evolve to keep pace with this rapidly changing field.
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