Comparison of Pulmonary Vein Isolation Versus AV Nodal Ablation With Biventricular Pacing for Patients With Atrial Fibrillation With Congestive Heart Failure (PABA CHF)

Inclusion Criteria: * Patients with symptomatic atrial fibrillation with NYHA II-III symptoms despite the use of anti-arrhythmic medications. * Ejection fraction was required to be ≤ 40%. * Patients were required to be on a heart failure regimen that included beta-blockers and ace-inhibitors or angiotensin receptor blockers for all patients and spironolactone for NYHA III patients. * Patients were required to complete a 6-minute walk test and to be ≥ 18 years of age. Exclusion Criteria: * Reversible causes of AF and heart failure (HF) such as pericarditis, hyperthyroidism, valvular heart disease and tachycardia-induced cardiomyopathy. * Post-operative AF, previous MAZE or MAZE-like surgery, previous left atrial instrumentation * Life expectancy ≤ 2 years * Likely cardiac transplant within the next 12 months * Contraindication to anti-arrhythmic medications and/or anticoagulation * Severe pulmonary disease * Documented intra-atrial thrombus * Tumor or other abnormalities which preclude catheter introduction * Cardiac surgery, MI or PCI within the past three months.