Heart failure (HF) and atrial fibrillation (AF) commonly coexist, adversely affect mortality, and impose a significant burden on healthcare resources. The presence of AF and HF portends a poor prognosis as well as an increased thromboembolic risk In patients whose AF is symptomatic, rhythm restoration with either antiarrhythmic drugs or procedural therapies (e.g., pulmonary vein isolation, either catheter-based or surgical) should be considered for symptom improvement, though a mortality benefit has yet to be demonstrated. Emerging evidence suggests that non-pharmacological treatment for AF (including catheter based ablation, hybrid surgical techniques, and attioventricular node ablation with biventricular pacing) may be of value in improving HF patients' quality of life. (C) 2015 Elsevier Inc. All rights reserved.