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 .
Radiofrequency ablation for persistent atrial fibrillation in patients with advanced heart failure and severe left ventricular systolic dysfunction: a randomised controlled trial
Objective To determine whether or not radiofrequency ablation ( RFA ) for persistent atrial fibrillation in patients with advanced heart failure leads to improvements in cardiac function . Setting Patients were recruited from heart failure outpatient clinics in Scotl and . Design and intervention Patients with advanced heart failure and severe left ventricular dysfunction were r and omised to RFA ( rhythm control ) or  continued medical treatment  ( rate control ) . Patients were followed up for a minimum of 6 months . Main outcome measure Change in left ventricular ejection fraction ( LVEF ) measured by cardiovascular MRI . Results 22 patients were r and omised to RFA and 19 to medical treatment . In the RFA group , 50 % of patients were in sinus rhythm at the end of the study ( compared with none in the medical treatment group ) . The increase in cardiovascular magnetic resonance ( CMR ) LVEF in the RFA group was 4.5±11.1 % compared with 2.8±6.7 % in the medical treatment group ( p=0.6 ) . The RFA group had a greater increase in radionuclide LVEF ( a prespecified secondary end point ) than patients in the medical treatment group ( + 8.2±12.0 % vs + 1.4±5.9 % ; p=0.032 ) . RFA did not improve N-terminal pro-B-type natriuretic peptide , 6 min walk distance or quality of life . The rate of serious complications related to RFA was 15 % . Conclusions RFA result ed in long-term restoration of sinus rhythm in only 50 % of patients . RFA did not improve CMR LVEF compared with a strategy of rate control . RFA did improve radionuclide LVEF but did not improve other secondary outcomes and was associated with a significant rate of serious complications . Clinical trials registration number NCT00292162
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 .