Please select the eligibility criteria that correspond to the clinical trial below.
Title: Catheter Ablation Versus Standard Conventional Treatment in Patients With Left Ventricular Dysfunction and Atrial Fibrillation
Brief Summary: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. The incidence and prevalence of AF increase exponentially with increasing age and AF is associated with higher mortality, more frequent hospitalization, and lower quality of life. Furthermore, AF is often associated with heart failure. The majority of AF is initiated by ectopic foci found primarily in the pulmonary veins. It was shown that catheter ablation of those veins could eliminate episodes of AF. In patients with heart failure, catheter ablation could improve cardiac function, symptoms and quality of life. It remains still unknown whether AF ablation is more effective than conventional treatment in terms of mortality and morbidity.


Options:
A: Inclusion Criteria:

* Symptomatic paroxysmal or persistent atrial fibrillation
* Failure or intolerance of antiarrhythmic drug therapy or unwillingness to take antiarrhythmic drugs
* Left Ventricular Ejection Fraction \<= 35%
* NYHA \>= II
* ICD for primary or secondary prevention with atrial sensing capabilities or Cardiac Resynchronization Therapy plus Defibrillator (CRT-D) device, both with Home Monitoring® technology already implanted
* Patient is willing and able to comply with the protocol and has written informed consent
* Age \>= 18 years

Exclusion Criteria:

* Contraindication for chronic anticoagulation therapy and heparin
* Documented left atrial diameter \> 6 cm
* Previous left heart ablation procedure for atrial fibrillation
* Acute coronary syndrome, cardiac surgery, angioplasty or stroke within 2 months prior to enrollment
* Untreated hypothyroidism or hyperthyroidism
* Enrollment in another investigational drug or device study
* Woman currently pregnant or breastfeeding or not using reliable contraceptive measures during fertility age
* Mental or physical inability to take part in the study
* Listed for heart transplant
* Cardiac assist device implanted
* Planned cardiovascular intervention
* Life expectancy ≤ 12 months
* Uncontrolled hypertension
* Requirement for dialysis due to terminal renal failure
* Participation in another telemonitoring concept
B: Inclusion Criteria:

1. Patients with an dual chamber ICD or CRTD (with an existing functional atrial lead) with remote monitoring capabilities and EF \<= 40% within the last 3 months by echocardiogram, nuclear imaging, MRI or cardiac catheterization,
2. Persistent or chronic symptomatic AF resistant to anti-arrhythmic medication other than Amiodarone. Resistant defined as recurrent AF of greater than 5 minutes duration at least once per month.
3. Therapeutic anticoagulation for at least three weeks prior to initiation of therapy
4. Ability to complete 6 minute walk test.
5. Age \>= 18 years old. (Females must be either post-menopausal \>12 months, practicing a protocol-acceptable method of birth control \[defined as injectable or implantable hormonal contraceptives, oral contraceptives, intrauterine device, diaphragm plus spermicide\], or have had a hysterectomy, bilateral oophorectomy, or tubal ligation performed at least 6 months prior to enrollment).
6. All patients optimized on CHF medications including beta-blocker and ace-inhibitor or angiotensin-receptor blocker.
7. patients receiving low dose amiodarone- \<200 mg for 2 or less months

Exclusion Criteria:

The exclusion criteria are:

1. Reversible causes of AF such as pericarditis, hyperthyroidism,
2. Presently with Valvular Heart disease requiring surgical intervention
3. Presently with coronary artery disease requiring surgical intervention
4. Early Post-operative AF (within three months of surgery)
5. Previous MAZE or left atrial instrumentation
6. Prolonged QT interval
7. Hypothyroidism
8. Liver Failure
9. Life expectancy \<= 2 years
10. Social factors that would preclude follow up or make compliance difficult.
11. Contraindication to the use of anti-arrhythmic medications and/or coumadin and heparin
12. Enrollment in another investigational drug or device study.
13. Patients with severe pulmonary disease i.e. COPD or asthma
14. Documented intra-atrial thrombus, tumor, or another abnormality which precludes catheter introduction
15. Any ophthalmologic disorders (other than requiring glasses for vision correction)
C: Inclusion Criteria:

* AF/AFL for \>72 hours and documented by 2 12-lead ECGs separated by at least 72 hours and indication for electrical cardioversion of the current AF/AFL episode as judged by the investigator.

Exclusion Criteria:

MAIN CRITERIA (non-exhaustive list):

* Women of childbearing potential without adequate birthcontrol, Pregnant Women, Breastfeeding women, conditions which increase the risk of severe antiarrhythmic drug side effects, permanent pacemaker, permanent AF/AFL, contraindication to anticoagulant, severe left ventricular dysfunction, severe associated conditions.
D: Inclusion Criteria:

* Written informed consent for participating in the study and written standard version of informed consent for cardioversion accepted in Institute of Cardiology, Warsaw, Poland
* Age above 18 and good general condition
* Potassium level over 3.5 mmol/l
* Stable cardio-pulmonary state on enrollment
* In case of unclear history of heart failure or suspicion of impaired left ventricle function echocardiography is indicated prior to enrollment
* A long-term antiarrhythmic drug therapy is allowed

Exclusion Criteria:

* Lack of written informed consent
* Antazoline allergy
* AF related to significant valvular disease
* Clinically significant heart failure or ejection fraction \< 55%
* Diastolic blood pressure (BP) \< 100mmHg
* History of significant bradyarrhythmia not treated with permanent pacemaker
* QT prolongation over 440ms or QTc (Bazett's formula) over population norm
* Tachycardia \> 160'
* Advanced liver or kidney failure
* Acute coronary syndrome, coronary artery by-pass graft, stroke or transient ischemic attack within 30 days before enrollment
* Preexcitation in ECG not treated by radiofrequency ablation of accessory pathway
* Signs and symptoms of ischemia related to AF
* An investigational drug used within 30 days before enrollment
* Pregnancy or breast feeding

Answer: A