Atrial fibrillation (AF) is common in patients with heart failure and is associated with a worse outcome. Previous studies of rhythm control using antiarrhythmic drugs have not shown any prognostic benefit in AF.1,2 Even in patients with heart failure, the large Atrial Fibrillation Congestive heart failure trial failed to show a benefit of amiodarone despite a marked reduction in AF burden.3 It has been suggested that antiarrhythmic drugs alone may not be powerful enough to maintain sinus rhythm, particularly in heart failure, or that the beneficial effects of sinus.
de Bono J et al. Eur Heart J. 2018;39:1324-1325.