Abstract
Atrial fibrillation and heart failure frequently co-exist with an increasing prevalence of atrial fibrillation as ejection fraction decreases. Atrial fibrillation is associated with increased mortality in patients with heart failure. This article will review rhythm and rate control options, ultimately supporting rhythm control via endocardial ablation. Randomized trials of a rhythm control strategy in patients with reduced ejection fraction heart failure have shown significant improvements in ejection fraction, oxygen consumption and also a significant reduction in mortality. The treatment of atrial fibrillation in patients with reduced ejection fraction heart failure should include an early rhythm control strategy via endocardial ablation.
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