Ablation for Atrial Fibrillation in Congestive Heart Failure

To the Editor: Hsu et al. report on a study (Dec. 2 issue) 1 of catheter ablation and its effect on rhythm control in patients with atrial fibrillation and heart failure to support the notion that drug-free maintenance of sinus rhythm may be superior to rate control. We want to stress, however, that apart from the acute risks associated with ablation, as noted by Stevenson and Stevenson in the accompanying editorial, 2 patients who have this treatment face a continuous threat of other problems after the procedure. First, some patients still have recurrences of atrial fibrillation that require antiarrhythmic drugs. Second, recurrences . . .