Atrial Fibrillation in Heart Failure - is There a Need for an Update of the Current Guidelines?

The relationship of atrial fibrillation and heart failure is not only coincidental but rather pathogenetically relevant. Lately, there have been some studies examining the influence of a treatment of atrial fibrillation on coexisting heart failure. The CASTLE-AF trial could show that catheter ablation of atrial fibrillation could ameliorate symptoms as well as prognosis of patients with atrial fibrillation and heart failure with reduced ejection fraction. Hence, catheter ablation of atrial fibrillation could be a crucial therapeutic option in these patients and becomes an essential part of future guidelines. Another aspect is the increasing use of sacubitril/valsartan for drug therapy of heart failure since there have been antiarrhythmic effects of it described in recently published studies.