Summary
Although Sessions AJ, et al. 7 stated that of course, the particular benefit in patients with an EF >35% suggests the need for prospective randomized control trial data in patients with HF to assess the role of ablation as a first-line therapy, we believe at present that 1) whether there is structural heart disease detected by cardiac MRI12 or scintigraphy and 2) whether the left atrial voltage is generally low, should be assessed “before ablation” in each patient with HF to achieve a successful ablation.