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Updated: May 29, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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Rate Versus Rhythm Control for Atrial Fibrillation with Heart Failure

Sanjeev Saksena1, April Slee2

  • 1Department of Medicine, Rutgers -Robert Wood Johnson Medical School, Piscataway, NJ, USA; Biostatistics, Electrophysiology Research Foundation, Warren, NJ, USA.

Cardiac Electrophysiology Clinics
|February 1, 2025
PubMed

Insights

Atrial fibrillation (AF) and heart failure (HF) are a growing epidemic. Newer rhythm control strategies, including catheter ablation, show promise for improving cardiovascular outcomes in patients with both conditions.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Atrial fibrillation (AF) and heart failure (HF) are increasingly prevalent, often co-existing cardiovascular conditions.
  • AF is a significant risk factor for HF progression and mortality.
  • Both conditions contribute to cardiac substrate disease in atria and ventricles.

Purpose of the Study:

  • To review the impact of AF on HF development and progression.
  • To evaluate the efficacy of contemporary rhythm control strategies in AF patients with HF.
  • To assess the role of catheter ablation in improving cardiovascular outcomes for AF with HF.

Main Methods:

  • Review of early studies comparing rate versus rhythm control in AF.
  • Analysis of recent evidence on modern antiarrhythmic drugs and catheter ablation for AF with HF.
  • Evaluation of outcomes in heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) populations.

Main Results:

  • Early studies showed no significant cardiovascular outcome benefit with older rhythm control strategies.
  • AF independently contributes to HF emergence and hospitalizations.
  • Current rhythm control strategies, including catheter ablation, demonstrate improved cardiovascular outcomes in AF with HF, particularly in HFrEF.

Conclusions:

  • Contemporary rhythm control, especially catheter ablation, offers benefits for patients with AF and HF.
  • Catheter ablation has shown positive effects on HF outcomes in HFrEF.
  • Larger studies are required to confirm benefits in HFpEF patients with AF.

Keywords:
Antiarhythmic drugsAtrial fibrillationCatheter ablationHeart failureHybrid therapyRhythm control

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