A randomized study concluded that catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) was associated with a significantly lower rate of death from any cause or hospitalization for worsening HF than was medical therapy. The study randomly assigned HF patients with symptomatic paroxysmal or persistent AF to undergo either catheter ablation (179 patients) or medical therapy (rate or rhythm control，184 patients) for AF in addition to guidelines-based therapy for HF. All the patients had New York Heart Association class II, III, or IV HF, a left ventricular ejection fraction of 35% or less, and an implanted defibrillator. After a median follow-up of 37.8 months, a composite of death from any cause or hospitalization for worsening HF occurred in significantly fewer patients in the ablation group than in the medical-therapy group (28.5% vs. 44.6%; hazard ratio, 0.62). Significantly fewer patients in the ablation group died from any cause (13.4% vs. 46 25.0%; hazard ratio, 0.53), were hospitalized for worsening HF (20.7% vs. 35.9%; hazard ratio, 0.56), or died from cardiovascular causes (11.2% vs. 22.3%; hazard ratio, 0.49). Source: http://www.nejm.org/
