Study population
This retrospective observational cohort study initially screened 4640 consecutive AF patients with available follow-up data from December 2017 to June 2021 in our institution. Then, 210 patients with concomitant HF were identified. HF was defined as either a history of HF hospitalization or symptoms and signs of HF with elevated N-terminal pro-B type natriuretic peptide (NT-ProBNP) (> 125 pg/ml with sinus rhythm or > 365 pg/ml with AF)11, 12. Patients with New York Heart Association (NYHA) class I or IV, acute decompensated HF or cardiogenic shock were not eligible. After exclusion of 79 patients with LVEF < 50%, severe valvular disease, congenital heart disease, 131 patients were finally included in the study (Figure 1). Severe valvular disease was defined as a history of aortic or mitral replacement or repair, evidence of severe aortic or mitral regurgitation, severe aortic stenosis, or moderate to severe mitral stenosis. The informed consent on receiving catheter ablation was obtained from all patients. This study complies with the Declaration of Helsinki and was approved by the local ethics committee. The data were acquired from routine patient care and all data used for this study were acquired for clinical purposes and handled anonymously.