Atrial fibrillation (AF) and heart failure (HF) often coexist leading to worse outcomes compared to AF or HF alone. According to the current guidelines, pulmonary vein isolation (PVI) as first-line therapy should be considered, however, the optimal timing of the procedure is still unknown. We aimed to investigate the effect of early PVI on all-cause mortality and AF recurrence in patients with HF. We analyzed the data of 162 patients with symptomatic paroxysmal or persistent AF and HF with LVEF < 50% who underwent PVI between 2010 and 2022. The patients’ medical history, laboratory results, echocardiographic and periprocedural parameters were collected in a structured registry. Early PVI was defined as catheter ablation performed within 12 months of AF diagnosis. The median follow-up was 59.7 months, the minimum follow-up was 12 months. Our primary endpoints were AF recurrence after a 3-months blanking period and all-cause mortality at any time during follow-up. Among the 162 patients, 77 (47.5%) experienced AF recurrence and 39 (24.1%) died during follow-up. The median age was 63.2 years. The median LVEF was 40% for early PVI and 37% for deferred PVI. Out of the 63 patients who underwent early PVI, 33 (52%) were taking amiodarone. Patients who underwent early PVI had longer freedom from recurrence compared to late PVI (median 833 days vs. median 696 days, respectively, p=0.02). Early PVI was a negative predictor of AF recurrence (HR: 0.58 [0.32-0.94], p=0.03). Early ablation had no beneficial impact on mortality (p=0.68). However, among those who experienced AF recurrence, repeat ablation was associated with better survival with univariate Cox regression (p=0.01). Furthermore, in multivariate model, repeat ablation was shown to be protective of mortality (HR: 0.312 [0.113-0.865], p=0.03) in the whole cohort. Our study shows that early rhythm control therapy with catheter ablation is more successful compared to deferred PVI in patients with AF and HF. A redo-PVI was associated with better survival, thus a repeat ablation should be considered in case of arrhythmia recurrence in patients with AF and HF to reduce mortality.