AF ablation in patients with systolic LV dysfunction results in significant improvement of LV function , but the extent of this improvement is heterogeneous .
Patients with coronary artery disease seem to benefit less than patients with other underlying diseases .
These results may be explained by patient selection
BACKGROUND Atrial fibrillation ( AF ) and heart failure are often coexisting major public health burdens .
Although several studies have reported partial restoration of systolic left ventricular ( LV ) function after catheter ablation for AF , the method is not widely applied in patients with LV dysfunction .
We review ed the results of AF ablation in patients with systolic LV dysfunction .
Ablation vs medical therapy in the setting of symptomatic atrial fibrillation and left ventricular dysfunction.
Small , single-center studies suggest that catheter ablation of atrial fibrillation ( AF )  can improve ventricular function and reduce symptoms in patients with left ventricular ( LV ) dysfunction . However , ablation has not been compared with a pharmacologic strategy for AF . The authors evaluated patients with AF and symptomatic LV dysfunction ( ejection fraction < or = 45 % ) referred for pulmonary vein isolation ( PVI ) . They compared these patients with a matched cohort treated medically for AF and LV dysfunction via a retrospective case-control method . Fifteen patients ( 14 men , 56+/-11 years , 10 [ 67 % ] paroxysmal AF ) with AF for 4+/-3 years underwent PVI .  Baseline ejection fraction was 37%+/-6 % and New York Heart Association ( NYHA ) class was 2.0+/-1.0 . Fifteen controls ( 13 men , 63+/-14 years , 11 [ 73 % ] paroxysmal AF ) with AF for 5+/-4 years were treated medically for AF . Baseline ejection fraction was 34%+/-11 % and NYHA class was 2.0+/-0.7 . The groups were similar in all respects . During a follow-up of 16+/-13 months after complete PVI , ejection fraction improved ( P=.001 ) to 50%+/-13 % and normalized in 8 patients ( 53 % ) . NYHA class improved to 1.3+/-0.5 ( P=.01 ) . In the medically treated group , after follow-up of 16+/-12 months , no improvement in ejection fraction ( 36%+/-12 % ) or NYHA class ( 1.8+/-0.7 ) was seen . Compared with pharmacologic therapy , PVI significantly improved LV function and NYHA class in patients with AF and symptomatic LV dysfunction . These provocative findings provide potent rationale for a r and omized clinical trial comparing ablation with pharmacologic therapy
AF ablation in patients with systolic LV dysfunction results in significant improvement of LV function , but the extent of this improvement is heterogeneous .
Patients with coronary artery disease seem to benefit less than patients with other underlying diseases .
These results may be explained by patient selection
BACKGROUND Atrial fibrillation ( AF ) and heart failure are often coexisting major public health burdens .
Although several studies have reported partial restoration of systolic left ventricular ( LV ) function after catheter ablation for AF , the method is not widely applied in patients with LV dysfunction .
We review ed the results of AF ablation in patients with systolic LV dysfunction .