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Atrial fibrillation (AF) confers a 5-fold increased risk of incident heart failure (HF) and a 2.5-fold increased risk of HF hospitalisation.

AF ablation improves HF outcomes in patients with pre-existing HF with reduced or preserved ejection fraction, but the optimal timing of AF ablation in patients with comorbid AF and HF is unknown. We hypothesise that early intervention for AF prevents the future development of HF. This randomised trial will compare inpatient AF ablation versus usual care among patients presenting to the emergency department with a primary diagnosis of AF who have no prior history of heart failure but risk factors for its development. The primary outcome will be survival free of incident heart failure.

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