Catheter Ablation of Atrial Fibrillation in Chronic Heart Failure: A Contemporary Review

Abstract

Catheter ablation of atrial fibrillation (AF) is a widely recommended treatment for patients presenting with symptomatic AF refractory to pharmacological treatment. AF ablation is also becoming a therapeutic option for patients with chronic heart failure (CHF), on top of optimal medical treatment, as AF is related to a higher risk of death, the worsening of symptoms, and the progression of CHF in this patient cohort. The present systematic review describes all published experiences concerning the use of AF catheter ablation among CHF patients and/or patients with structural cardiomyopathies, in an effort to summarize procedural safety and efficacy in this specific setting. Moreover, the effects of AF ablation on functional class and quality of life, as well as the different procedural protocols available, are presented and discussed, aiming to provide an evidence-based clinical perspective to optimize indication and tailor procedural characteristics and endpoints to patients affected by CHF referred for AF ablation.