Parkash R, Wells G, Rouleau J, et al. - Researchers described rationale and methods for a multi-centre prospective randomized open blinded endpoint (PROBE) study to ascertain if atrial fibrillation (AF) managed by catheter ablation, with or without antiarrhythmic drugs decreases all-cause death and hospitalizations for heart failure (HF) vs rate control in patients experiencing HF and a high burden AF. Participants are patients having NYHA class II-III HF (HF with reduced ejection fraction (< 35%) or HF with preserved ejection fraction), and high burden AF. These are randomly assigned, in a 1:1 ratio, to either rate control or catheter ablation-based AF rhythm control. A composite of all-cause death and hospitalization for heart failure is the primary outcome. The sample size is 600. Enrolment is done. Previous reports show mixed results on sinus rhythm to improve heart failure. In these patients, if catheter ablation confers benefit as first line therapy is not known. If benefit is confirmed, the findings will change how these patients are treated.