AVJ Ablation Followed by Resynchronization Therapy in Patients With CHF and AF

Inclusion Criteria:

Symptomatic permanent AF
Class I or II indication for ICD
LVEF ≤ 35% within 6 months
NYHA class II or III with a history of CHF
Maximal tolerated drug therapy for CHF and rate control with a stable regimen for ≥ 30 days
Ability to independently comprehend and complete a QoL questionnaire
Ability to give informed consent for study participation and willingness and ability to comply with prescribed follow-up tests and scheduled evaluations

Exclusion Criteria:

Paroxysmal or persistent AF
Class I indication for pacing (including AVJ ablation for poor rate control)
Ability to walk ≥ 450 meters in 6 minutes
Musculoskeletal disorders that prohibit the completion of a 450 meters walk
NYHA class I or IV at the time of enrollment
A contraindication to taking Coumadin therapy
History of myocardial infarction, percutanous coronary intervention, or CABG in the past 30 days
History of mitral valve surgery
Prior attempts for cardiac resynchronization therapy
The presence of an existing coronary sinus lead or epicardial lead
Life expectancy < 1year
Age < 18 yrs
Current participation in other clinical studies except registry trials
Use of calcium channel blockers
Pregnancy
Inability to give informed consent