Abstract
The AFFIRM Trial showed a trend forward harm for a strategy of rhythm control among patients with persistent atrial fibrillation (AF). However, it is still uncertain whether this finding applies to patients with heart failure (HF). We studied a group of 74 patients with advanced HF, (age 58±7 yrs LVEF 28±7%; NYHA class 2.7±0.5), permanent AF and a previous failed external cardioversion, to assess the potential benefit of an aggressive rhythm control strategy including internal cardioversion, preceded and followed by amiodarone treatment (400 mg/day for 4-6 weeks and 200-300 mg/day, respectively.
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