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Rhythm Control of Atrial Fibrillation in Heart Failure with Reduced Ejection Fraction

  • Heart Failure (HJ Eisen, Section Editor)
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Abstract

Purpose of Review

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.

Recent Findings

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.

Summary

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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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Marrouche N, Brachmann J, Anderson D, Siebels J, Boersma L, Jordaens L, et al. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018;378(5):417–27. https://doi.org/10.1056/NEJMoa1707855This is the first and thus far only study to evaluate and demonstrate a reduction in mortality in patients with reduced ejection fraction heart failure that underwent ablation for atrial fibrillation.

    Article  PubMed  Google Scholar 

  2. Santhanakrishnan R, Wang N, Larson MG, Magnani JW, McManus DD, Lubitz SA, et al. Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133(5):484–92. https://doi.org/10.1161/CIRCULATIONAHA.115.018614.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107(23):2920–5. https://doi.org/10.1161/01.CIR.0000072767.89944.6E.

    Article  PubMed  Google Scholar 

  4. Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol. 2003;91(6A):2D–8D. https://doi.org/10.1016/s0002-9149(02)03373-8.

    Article  PubMed  Google Scholar 

  5. Vermes E, Ducharme A, Bourassa MG, Lessard M, White M, Tardif JC. Studies Of Left Ventricular Dysfunction. Enalapril reduces the incidence of diabetes in patients with chronic heart failure: insight from the Studies Of Left Ventricular Dysfunction (SOLVD). Circulation. 2003;107(9):1291–6. https://doi.org/10.1161/01.cir.0000054611.89228.92.

    Article  CAS  PubMed  Google Scholar 

  6. Maggioni AP, Latini R, Carson PE, Singh SN, Barlera S, Glazer R, et al. Val-HeFT Investigators. Valsartan reduces the incidence of atrial fibrillation in patients with heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT). Am Heart J. 2005;149(3):548–57. https://doi.org/10.1016/j.ahj.2004.09.033.

    Article  CAS  PubMed  Google Scholar 

  7. Ducharme A, Swedberg K, Pfeffer MA, Cohen-Solal A, Granger CB, Maggioni AP, et al. Prevention of atrial fibrillation in patients with symptomatic chronic heart failure by candesartan in the Candesartan in Heart failure: assessment of Reduction in Mortality and morbidity (CHARM) program [published correction appears in Am Heart J. 2006 Aug;152(2):354]. Am Heart J. 2006;151(5):985–91. https://doi.org/10.1016/j.ahj.2005.06.036.

    Article  PubMed  Google Scholar 

  8. Olsson LG, Swedberg K, Ducharme A, Granger CB, Michelson EL, McMurray J, et al. CHARM Investigators. Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: results from the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) program. J Am Coll Cardiol. 2006;47(10):1997–2004. https://doi.org/10.1016/j.jacc.2006.01.060.

    Article  PubMed  Google Scholar 

  9. JGF C, Bunting KV, Flather MD, Altman DG, Holmes J, AJS C, et al. Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. Eur Heart J. 2018;39(1):26–35. https://doi.org/10.1093/eurheartj/ehx564.

    Article  CAS  Google Scholar 

  10. Swedberg K, Zannad F, McMurray JJ, Krum H, van Veldhuisen D, Shi H, et al. Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure) study. J Am Coll Cardiol. 2012;59(18):1598–603. https://doi.org/10.1016/j.jacc.2011.11.063.

    Article  CAS  PubMed  Google Scholar 

  11. Myhre PL, Vaduganathan M, Claggett B, Packer M, Desai AS, Rouleau JL, et al. B-type natriuretic peptide during treatment with sacubitril/valsartan: the PARADIGM-HF trial. J Am Coll Cardiol. 2019;73(11):1264–72. https://doi.org/10.1016/j.jacc.2019.01.018.

    Article  CAS  PubMed  Google Scholar 

  12. Olsson LG, Swedberg K, Cleland JG, et al. Prognostic importance of plasma NT-pro BNP in chronic heart failure in patients treated with a beta-blocker: results from the Carvedilol Or Metoprolol European Trial (COMET) trial. Eur J Heart Fail. 2007;9(8):795–801. https://doi.org/10.1016/j.ejheart.2007.07.010.

    Article  CAS  PubMed  Google Scholar 

  13. Masson S, Latini R, Anand IS, Barlera S, Angelici L, Vago T, et al. Val-HeFT Investigators. Prognostic value of changes in N-terminal pro-brain natriuretic peptide in Val-HeFT (Valsartan Heart Failure Trial). J Am Coll Cardiol. 2008;52(12):997–1003. https://doi.org/10.1016/j.jacc.2008.04.069.

    Article  CAS  PubMed  Google Scholar 

  14. Shin DI, Jaekel K, Schley P, Sause A, Müller M, Fueth R, et al. Plasma levels of NT-pro-BNP in patients with atrial fibrillation before and after electrical cardioversion. Z Kardiol. 2005;94(12):795–800. https://doi.org/10.1007/s00392-005-0301-7.

    Article  CAS  PubMed  Google Scholar 

  15. Solheim E, Off MK, Hoff PI, de Bortoli A, Schuster P, Ohm OJ, et al. N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation. J Interv Card Electrophysiol. 2012;34(2):129–36. https://doi.org/10.1007/s10840-011-9629-2.

    Article  PubMed  Google Scholar 

  16. Mogensen UM, Jhund PS, Abraham WT, Desai AS, Dickstein K, Packer M, et al. PARADIGM-HF and ATMOSPHERE Investigators and Committees. Type of atrial fibrillation and outcomes in patients with heart failure and reduced ejection fraction. J Am Coll Cardiol. 2017;70(20):2490–500. https://doi.org/10.1016/j.jacc.2017.09.027.

    Article  PubMed  Google Scholar 

  17. Zafrir B, Lund LH, Laroche C, Ruschitzka F, Crespo-Leiro MG, AJS C, et al. Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: a report from 14 964 patients in the European Society of Cardiology Heart Failure Long-Term Registry. Eur Heart J. 2018;39(48):4277–84. https://doi.org/10.1093/eurheartj/ehy626.

    Article  CAS  PubMed  Google Scholar 

  18. Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med. 1991;324(12):781–8. https://doi.org/10.1056/NEJM199103213241201.

    Article  CAS  PubMed  Google Scholar 

  19. Køber L, Torp-Pedersen C, McMurray JJ, Gøtzsche O, Lévy S, Crijns H, et al. Increased mortality after dronedarone therapy for severe heart failure [published correction appears in N Engl J Med. 2010 Sep 30;363(14):1384]. N Engl J Med. 2008;358(25):2678–87. https://doi.org/10.1056/NEJMoa0800456.

    Article  PubMed  Google Scholar 

  20. Waldo AL, Camm AJ. deRuyter H, et al. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol [published correction appears in Lancet 1996 Aug 10;348(9024):416]. Lancet. 1996;348(9019):7–12. https://doi.org/10.1016/s0140-6736(96)02149-6.

    Article  CAS  PubMed  Google Scholar 

  21. Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347(23):1825–33. https://doi.org/10.1056/NEJMoa021328.

    Article  CAS  PubMed  Google Scholar 

  22. Rathore SS, Curtis JP, Wang Y, Bristow MR, Krumholz HM. Association of serum digoxin concentration and outcomes in patients with heart failure. JAMA. 2003;289(7):871–8. https://doi.org/10.1001/jama.289.7.871.

    Article  CAS  PubMed  Google Scholar 

  23. Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN. Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators. Circulation. 1998;98(23):2574–9. https://doi.org/10.1161/01.cir.98.23.2574.

    Article  CAS  PubMed  Google Scholar 

  24. Corley SD, Epstein AE, DiMarco JP, et al. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation. 2004;109(12):1509–13. https://doi.org/10.1161/01.CIR.0000121736.16643.11.

    Article  PubMed  Google Scholar 

  25. Torp-Pedersen C, Møller M, Bloch-Thomsen PE, Køber L, Sandøe E, Egstrup K, et al. Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group. N Engl J Med. 1999;341(12):857–65. https://doi.org/10.1056/NEJM199909163411201.

    Article  CAS  PubMed  Google Scholar 

  26. Pedersen OD, Bagger H, Keller N, Marchant B, Køber L, Torp-Pedersen C. Efficacy of dofetilide in the treatment of atrial fibrillation-flutter in patients with reduced left ventricular function: a Danish investigations of arrhythmia and mortality on dofetilide (diamond) substudy. Circulation. 2001;104(3):292–6. https://doi.org/10.1161/01.cir.104.3.292.

    Article  CAS  PubMed  Google Scholar 

  27. Hagens VE, Crijns HJ, Van Veldhuisen DJ, et al. Rate control versus rhythm control for patients with persistent atrial fibrillation with mild to moderate heart failure: results from the RAte Control versus Electrical cardioversion (RACE) study. Am Heart J. 2005;149(6):1106–11. https://doi.org/10.1016/j.ahj.2004.11.030.

    Article  PubMed  Google Scholar 

  28. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147–239. https://doi.org/10.1016/j.jacc.2013.05.019.

    Article  PubMed  Google Scholar 

  29. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society [published correction appears in J Am Coll Cardiol. 2014 Dec 2;64(21):2305–7]. J Am Coll Cardiol. 2014;64(21):e1–e76. https://doi.org/10.1016/j.jacc.2014.03.022.

    Article  PubMed  Google Scholar 

  30. Roy D, Talajic M, Nattel S, Wyse DG, Dorian P, Lee KL, et al. Atrial Fibrillation and Congestive Heart Failure Investigators. Rhythm control versus rate control for atrial fibrillation and heart failure. N Engl J Med. 2008;358(25):2667–77. https://doi.org/10.1056/NEJMoa0708789.

    Article  CAS  PubMed  Google Scholar 

  31. Shelton RJ, Clark AL, Goode K, Rigby AS, Houghton T, Kaye GC, et al. A randomised, controlled study of rate versus rhythm control in patients with chronic atrial fibrillation and heart failure: (CAFE-II Study). Heart. 2009;95(11):924–30. https://doi.org/10.1136/hrt.2008.158931.

    Article  CAS  PubMed  Google Scholar 

  32. Talajic M, Khairy P, Levesque S, Connolly SJ, Dorian P, Dubuc M, et al. Maintenance of sinus rhythm and survival in patients with heart failure and atrial fibrillation [published correction appears in J Am Coll Cardiol. 2010 Jun 15;55(24):2788. AF-CHF Investigators [added]]. J Am Coll Cardiol. 2010;55(17):1796–802. https://doi.org/10.1016/j.jacc.2010.01.023.

    Article  PubMed  Google Scholar 

  33. Mercer BN, Koshy A, Drozd M, Walker AMN, Patel PA, Kearney L, et al. Ischemic heart disease modifies the association of atrial fibrillation with mortality in heart failure with reduced ejection fraction. J Am Heart Assoc. 2018;7(20):e009770. https://doi.org/10.1161/JAHA.118.009770.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Sartipy U, Dahlström U, Fu M, Lund LH. Atrial fibrillation in heart failure with preserved, mid-range, and reduced ejection fraction. JACC Heart Fail. 2017;5(8):565–74. https://doi.org/10.1016/j.jchf.2017.05.001.

    Article  PubMed  Google Scholar 

  35. Khan MN, Jaïs P, Cummings J, di Biase L, Sanders P, Martin DO, et al. Pulmonary-vein isolation for atrial fibrillation in patients with heart failure. N Engl J Med. 2008;359(17):1778–85. https://doi.org/10.1056/NEJMoa0708234.

    Article  CAS  PubMed  Google Scholar 

  36. Packer DL, Mark DB, Robb RA, Monahan KH, Bahnson TD, Poole JE, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA. 2019;321(13):1261–74. https://doi.org/10.1001/jama.2019.0693.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Solomon SD, Anavekar N, Skali H, McMurray JJV, Swedberg K, Yusuf S, et al. Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients. Circulation. 2005;112(24):3738–44. https://doi.org/10.1161/CIRCULATIONAHA.105.561423.

    Article  PubMed  Google Scholar 

  38. MacDonald MR, Connelly DT, Hawkins NM, et al. Radiofrequency ablation for persistent atrial fibrillation in patients with advanced heart failure and severe left ventricular systolic dysfunction: a randomised controlled trial. Heart. 2011;97(9):740–7. https://doi.org/10.1136/hrt.2010.207340.

    Article  PubMed  Google Scholar 

  39. Jones DG, Haldar SK, Hussain W, Sharma R, Francis DP, Rahman-Haley SL, et al. A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in heart failure. J Am Coll Cardiol. 2013;61(18):1894–903. https://doi.org/10.1016/j.jacc.2013.01.069.

    Article  PubMed  Google Scholar 

  40. Francis DP, Shamim W, Davies LC, Piepoli MF, Ponikowski P, Anker SD, et al. Cardiopulmonary exercise testing for prognosis in chronic heart failure: continuous and independent prognostic value from VE/VCO(2)slope and peak VO(2). Eur Heart J. 2000;21(2):154–61. https://doi.org/10.1053/euhj.1999.1863.

    Article  CAS  PubMed  Google Scholar 

  41. Hunter RJ, Berriman TJ, Diab I, Kamdar R, Richmond L, Baker V, et al. A randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure (the CAMTAF trial). Circ Arrhythm Electrophysiol. 2014;7(1):31–8. https://doi.org/10.1161/CIRCEP.113.000806.

    Article  CAS  PubMed  Google Scholar 

  42. • Di Biase L, Mohanty P, Mohanty S, et al. Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial. Circulation. 2016;133(17):1637–44. https://doi.org/10.1161/CIRCULATIONAHA.115.019406This was a randomized trial with secondary endpoints demonstrating reduction in hospitalizations and mortality in those that underwent ablation. This trial was additionally unique in that patients were implanted with a transvenous system to ensure a more accurate assessment of atrial fibrillation recurrence.

    Article  CAS  PubMed  Google Scholar 

  43. Noseworthy PA, Van Houten HK, Gersh BJ, et al. Generalizability of the CASTLE-AF trial: catheter ablation for patients with atrial fibrillation and heart failure in routine practice [published online ahead of print, 2020 Mar 4]. Heart Rhythm. 2020;S1547–5271(20):30183–1. https://doi.org/10.1016/j.hrthm.2020.02.030.

    Article  Google Scholar 

  44. Hayes DL, Boehmer JP, Day JD, Gilliam FR III, Heidenreich PA, Seth M, et al. Cardiac resynchronization therapy and the relationship of percent biventricular pacing to symptoms and survival. Heart Rhythm. 2011;8(9):1469–75. https://doi.org/10.1016/j.hrthm.2011.04.015.

    Article  PubMed  Google Scholar 

  45. Santini M, Gasparini M, Landolina M, Lunati M, Proclemer A, Padeletti L, et al. Device-detected atrial tachyarrhythmias predict adverse outcome in real-world patients with implantable biventricular defibrillators. J Am Coll Cardiol. 2011;57(2):167–72. https://doi.org/10.1016/j.jacc.2010.08.624.

    Article  PubMed  Google Scholar 

  46. Ousdigian KT, Borek PP, Koehler JL, Heywood JT, Ziegler PD, Wilkoff BL. The epidemic of inadequate biventricular pacing in patients with persistent or permanent atrial fibrillation and its association with mortality. Circ Arrhythm Electrophysiol. 2014;7(3):370–6. https://doi.org/10.1161/CIRCEP.113.001212.

    Article  PubMed  Google Scholar 

  47. Kamath GS, Cotiga D, Koneru JN, Arshad A, Pierce W, Aziz EF, et al. The utility of 12-lead Holter monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy. J Am Coll Cardiol. 2009;53(12):1050–5. https://doi.org/10.1016/j.jacc.2008.12.022.

    Article  PubMed  Google Scholar 

  48. Yin J, Hu H, Wang Y, Xue M, Li X, Cheng W, et al. Effects of atrioventricular nodal ablation on permanent atrial fibrillation patients with cardiac resynchronization therapy: a systematic review and meta-analysis. Clin Cardiol. 2014;37(11):707–15. https://doi.org/10.1002/clc.22312.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Gasparini M, Auricchio A, Regoli F, Fantoni C, Kawabata M, Galimberti P, et al. Four-year efficacy of cardiac resynchronization therapy on exercise tolerance and disease progression: the importance of performing atrioventricular junction ablation in patients with atrial fibrillation. J Am Coll Cardiol. 2006;48(4):734–43. https://doi.org/10.1016/j.jacc.2006.03.056.

    Article  PubMed  Google Scholar 

  50. Brignole M, Pokushalov E, Pentimalli F, Palmisano P, Chieffo E, Occhetta E, et al. A randomized controlled trial of atrioventricular junction ablation and cardiac resynchronization therapy in patients with permanent atrial fibrillation and narrow QRS. Eur Heart J. 2018;39(45):3999–4008. https://doi.org/10.1093/eurheartj/ehy555.

    Article  CAS  PubMed  Google Scholar 

  51. Hess PL, Sheng S, Matsouaka R, DeVore AD, Heidenreich PA, Yancy CW, et al. Strict versus lenient versus poor rate control among patients with atrial fibrillation and heart failure (from the Get With The Guidelines - Heart Failure Program). Am J Cardiol. 2020;125(6):894–900. https://doi.org/10.1016/j.amjcard.2019.12.025.

    Article  PubMed  Google Scholar 

  52. Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362(15):1363–73. https://doi.org/10.1056/NEJMoa1001337.

    Article  PubMed  Google Scholar 

  53. Prabhu S, Taylor AJ, Costello BT, Kaye DM, McLellan AJA, Voskoboinik A, et al. Catheter ablation versus medical rate control in atrial fibrillation and systolic dysfunction: the CAMERA-MRI study. J Am Coll Cardiol. 2017;70(16):1949–61. https://doi.org/10.1016/j.jacc.2017.08.041.

    Article  PubMed  Google Scholar 

  54. Wu L, Narasimhan B, Haddadin F, et al. Safety and complications of catheter ablation for atrial fibrillation in the United States: an updated analysis from the National Inpatient Sample Database. J AM Coll Cardiol. 2020;75(11 Supplement 1):271. https://doi.org/10.1016/S0735-1097(20)30898-6.

    Article  Google Scholar 

  55. Ruzieh M, Foy AJ, Aboujamous NM, et al. Meta-analysis of atrial fibrillation ablation in patients with systolic heart failure. Cardiovasc Ther. 2019;2019:8181657. Published 2019 Jan 6. https://doi.org/10.1155/2019/8181657.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Jarman JWE, Hussain W, Wong T, et al. Resource use and clinical outcomes in patients with atrial fibrillation with ablation versus antiarrhythmic drug treatment. BMC Cardiovasc Disord. 2018;18(1):211. Published 2018 Nov 7. https://doi.org/10.1186/s12872-018-0946-6.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Biviano AB, Hunter TD, Dandamudi G, et al. Healthcare utilization and quality of life improvement after ablation for paroxysmal AF in younger and older patients. Pacing Clin Electrophysiol. 2017;40(4):391–400. https://doi.org/10.1111/pace.13041.

    Article  PubMed  Google Scholar 

  58. Chang AY, Kaiser D, Ullal A, Perino AC, Heidenreich PA, Turakhia MP. Evaluating the cost-effectiveness of catheter ablation of atrial fibrillation. Arrhythm Electrophysiol Rev. 2014;3(3):177–83. https://doi.org/10.15420/aer.2014.3.3.177.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Piorkowski C, Kronborg M, Hourdain J, Piorkowski J, Kirstein B, Neudeck S, et al. Endo-/epicardial catheter ablation of atrial fibrillation: feasibility, outcome, and insights into arrhythmia mechanisms. Circ Arrhythm Electrophysiol. 2018;11(2):e005748. https://doi.org/10.1161/CIRCEP.117.005748.

    Article  PubMed  Google Scholar 

  60. Chung MK, Refaat M, Shen WK, Kutyifa V, Cha YM, di Biase L, et al. Atrial fibrillation: JACC Council perspectives. J Am Coll Cardiol. 2020;75(14):1689–713. https://doi.org/10.1016/j.jacc.2020.02.025.

    Article  PubMed  Google Scholar 

  61. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society [published correction appears in J Am Coll Cardiol. 2019 Jul 30;74(4):599]. J Am Coll Cardiol. 2019;74(1):104–32. https://doi.org/10.1016/j.jacc.2019.01.011.

    Article  PubMed  Google Scholar 

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  1. Heart and Vascular Institute, Penn State University College of Medicine, 500 University Drive, PO Box 850, Hershey, PA, 17033, USA

    Gregory Burkman & Gerald V. Naccarelli

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Burkman, G., Naccarelli, G.V. Rhythm Control of Atrial Fibrillation in Heart Failure with Reduced Ejection Fraction. Curr Cardiol Rep 22, 83 (2020). https://doi.org/10.1007/s11886-020-01336-8

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