Abstract
Not only are atrial fibrillation (AF) and heart failure (HF) the most commonly encountered disease conditions in clinical practice, they are also associated with an increased risk of both morbidity and mortality. Both diseases are affiliated with maladaptive neurohormonal changes and remodelling of the heart. Treatment of AF has focused on prevention of thromboembolism, rate control and rhythm maintenance. Rhythm maintenance with anti-arrhythmic drugs has been relatively ineffective in maintaining patients in sinus rhythm, with the addition of increased adverse side effects. Rhythm control of AF via catheter radiofrequency ablation is a viable treatment option, with several studies showing improvement in ejection fraction, quality of life and the six-minute-walk test. Future multicentre randomised controlled trials are pending, the first being Catheter Ablation Versus Standard Conventional Treatment in Patients With Left Ventricular Dysfunction and Atrial Fibrillation (CASTLE-AF), to determine whether catheter ablation of AF is superior to conventional therapy for patients suffering from AF and HF.
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