Please select the eligibility criteria that correspond to the clinical trial below.
Title: Catheter Ablation Versus Medical Treatment of AF in Heart Failure
Brief Summary: Heart failure and atrial fibrillation (AF) often coexist, and each increases the morbidity and mortality associated with the other. The investigators hypothesized that restoration of normal sinus rhythm by catheter ablation is superior to medical treatment of AF in heart failure. This study randomizes patients with heart failure and persistent AF to medical treatment of AF or catheter ablation to restore sinus rhythm.


Options:
A: Inclusion Criteria:

* Persistent atrial fibrillation
* Symptomatic heart failure

Exclusion Criteria:

* Reversible causes of heart failure
* Contraindications to catheter ablation
B: Inclusion criteria:

* Age ≥ 18 years, \< 80years
* NYHA II-IV symptoms
* Impairment of left ventricular systolic function (left ventricular ejection fraction estimated as ≤ 35% by radionuclide ventriculography)
* Documented AF lasting for at least 7 days (persistent or permanent AF)

Exclusion criteria:

* CRT or ICD device implanted in the previous 6 months
* AV nodal ablation within previous 3 months
* Prior AV nodal ablation or complete heart block with a single chamber pacemaker
* Contraindication to anticoagulation
* Persistent thrombus in the left atrium despite anticoagulation
* Active malignancy
* Cerebrovascular accident within the previous 6 months
* Reversible causes of AF including thyroid disorders, alcohol, recent surgery
* Reversible causes of heart failure including acute myocarditis or alcohol
* Cardiac events including myocardial infarction (MI), percutaneous coronary intervention (PCI), valve or coronary bypass surgery within the previous 3 months
* Prior AF ablation procedure
* Previous heart transplant, or on urgent heart transplant waiting list
* Severe neuro-muscular disease
* Creatinine clearance \<30 ml/min
* Serum bilirubin \>50 micromol/L
* Active participation in another research study
* Unable to understand and comply with protocol or give written informed consent
* Body mass index \>35 (kg/m2)
C: Inclusion Criteria:

* Patients with- in 12-Channel-ECG documented atrial tachycardia suggestive of typical isthmus dependent atrial flutter
* \> 21 years

Exclusion Criteria:

* - AFL as secondary to an accessory pathway
* Antiarrhythmic treatment for AF
* AF
* Previous AF ablation
* Dilatation of left atrium \> 6 cm
* Cardiac surgery less \< 3 weeks
* Congenital heart disease
* Cardiac ischemia or coronary artery disease that needs intervention
* Life expectancy less than 2 years
D: Inclusion Criteria:

* Patients ≤ 70 years of age
* Paroxysmal atrial fibrillation patients who are considered as being candidates for antiarrhythmic drug therapy initiation
* Patients who have had at least two episodes of symptomatic paroxysmal atrial fibrillation in the foregoing 6 months can be included. The atrial fibrillation episodes may be persistent (need DC- or AAD-conversion) with a duration of less than 7 days.

Exclusion Criteria:

* Previous or ongoing chronic treatment with class IC or class III antiarrhythmic drugs
* Intolerance/contraindication to class IC and class III antiarrhythmic drugs (i.e. intolerance/contraindication to only one of the two groups is not excluding the patient)
* Previous atrial fibrillation ablation
* Severely increased left atrial size
* Left ventricular ejection fraction below 0.40 (during sinus rhythm or atrial fibrillation with RR-intervals above 600 ms) or "eye-balled" reduction of systolic function to less than "moderately decreased".
* Contraindication to anticoagulation treatment with vitamin K antagonists
* Expected surgery for structural heart disease within the follow-up period Significant mitral valve disease
* New York Heart Association (NYHA) III-IV
* Planned pregnancy within the follow-up period
* Secondary atrial fibrillation (e.g. post-surgery, infections, hyperthyroidism)
* Age \< 18 years
* Patient does not want to participate.

Answer: A