The management of atrial fibrillation comprises three domains that have a prognostic impact in terms of prolonged survival and prevention of serious complications. These include hemodynamic stabilization, detection and treatment of underlying cardiovascular diseases, and assessment of stroke risk. If performed in experienced centers – says Paulus Kirchhof -, catheter ablation of AF is one of the main treatment options for rhythm control that may be offered to all patients who remain symptomatic on optimal rate control therapy. AF patients with concomitant heart failure represent a challenging population requiring specific therapy.