Atrial arrhythmias in heart failure with a reduced ejection fraction

Thomas A. Dewland, Babak Nazer

Research output: Contribution to journalReview articlepeer-review


Purpose of reviewAtrial arrhythmias are common among individuals with heart failure with a reduced ejection fraction (HFrEF). This review describes management options for these arrhythmias and discusses emerging clinical data supporting catheter ablation.Recent findingsSeveral recent clinical trials indicate that catheter ablation is superior to pharmacologic therapy for management of symptomatic atrial fibrillation in the setting of HFrEF. Restoration and maintenance of sinus rhythm appears to have the greatest benefit with regard to ejection fraction improvement among individuals with a nonischemic heart failure etiology and minimal left ventricular fibrosis.SummaryA rhythm control strategy should be strongly considered in patients with HFrEF, especially when the atrial arrhythmia is symptomatic or is present at the time of a heart failure diagnosis. Catheter ablation may be the preferred strategy for maintenance of sinus rhythm in this patient population.

Original languageEnglish (US)
Pages (from-to)271-275
Number of pages5
JournalCurrent Opinion in Cardiology
Issue number3
StatePublished - 2020


  • antiarrhythmic drug therapy
  • arrhythmia associated cardiomyopathy
  • catheter ablation
  • pulmonary vein isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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