Compared to medical therapy, catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) was associated with a significantly lower rate of a composite end point of death from any cause or hospitalization from worsening HF, a recent study found. Patients with symptomatic paroxysmal or persistent AF who did not have a response to antiarrhythmic drugs, had unacceptable side effects, or were unwilling to take these drugs to undergo either catheter ablation (179 patients) or medical therapy (184 patients) for AF in addition to guideline-based therapy for HF, were randomly assigned. The primary end point was a composite of death from any cause or hospitalization for worsening HF. Among the findings:

• The primary composite end point occurred in significantly fewer patients in the ablation group vs the medical-therapy group (51 patients [29%] vs 82 patients [45%]; HR, 0.62) after median follow-up of 37.8 months.
• Significantly fewer patients in the ablation group died from any cause (24 vs 46; HR, 0.53), were hospitalized for worsening HF (37 [21%] vs 66 [36%]; HR, 0.56), or died from CV causes (20 [11%] vs 41 [22%]; HR, 0.49).