Building Castles in the Sky: Catheter Ablation in Patients With Atrial Fibrillation and Chronic Heart Failure
Atrial fibrillation is part of the medical history in >30% of patients with heart failure and a reduced ejection fraction and in >50% of those with a preserved ejection fraction. In general, the arrhythmia does not cause heart failure; but does it contribute to progression of the disease? The treatment of atrial fibrillation has advanced over the past 20 years, as we have moved from antiarrhythmic drugs to catheter ablation. Yet, is intervention beneficial? It is important to relieve disabling symptoms due to paroxysms of the arrhythmia, but this is a valid goal whether heart failure exists or not. However, for most patients with heart failure and atrial fibrillation, control of the ventricular response and systemic anticoagulation are all that is required.
- Received February 25, 2018.
- Accepted March 15, 2018.