Conditions: Chronic Heart Failure Atrial Fibrillation
Keywords: Chronic Heart Failure Atrial Fibrillation Radiofrequency Ablation
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 41
Healthy volunteers: no

Brief summary:
Heart failure is a condition that occurs when the heart muscle weakens and no longer contracts normally. Half of these patients have an irregularity of heart rhythm called atrial fibrillation (AF). Patients with both heart failure and AF spend more time in hospital, and die earlier than those with heart failure alone. AF is difficult to treat with conventional methods in patients with heart failure. Radiofrequency ablation is a new technique used to cure AF. The investigators aim to establish if radiofrequency ablation for atrial fibrillation in patients with advanced heart failure can result in marked improvement in the function of the heart.

Detailed description:

Arms:
arm 1: Standard therapy for heart failure with angiotensin converting enzyme inhibitors(ACE) - (Ramipril, enalapril, lisinopril, captopril, perindopril), beta-blocker (BB) - (carvedilol, bisoprolol, metoprolol), Aldosterone antagonists (spironolactone) +/- diuretics and digoxin arm 2: Isolation of the pulmonary veins using radiofrequency ablation

Interventions: intervention 1: radiofrequency ablation intervention 2: ACE inhibitor - ramipril, enalapril, captopril, perindopril, lisinopril intervention 3: Beta Blocker (BB) - metoprolol, bisoprolol, carvedilol intervention 4: Aldosterone Antagonists - spironolactone
Intervention descriptions: intervention 1: isolation of the pulmonary veins with radiofrequency ablation (RFA) intervention 2: Evidence based treatment for heart failure. Dose and type will depend on patient tolerability. intervention 3: Evidence based treatment for heart failure. Dose and type will depend on patient tolerance. intervention 4: Evidence based treatment for heart failure. Dose and type will depend on patient to treatment.

Protocol document: