Heart failure (HF) and atrial fibrillation (AF) are common cardiovascular disorders that frequently complicate one another. Atrial fibrillation can provoke left ventricular (LV) dysfunction causing the loss of atrial contraction, rapid ventricular rates, and irregular ventricular rhythm. Dysfunction of left ventricle includes haemodynamic stress, activation of neurohormonal systems, myocardial remodelling and induction of apoptosis, cell death and replacement fibrosis. There is a great role of other contributing factors in those patients susceptible to LV dysfunction such as genetic mutations- for instance, a higher frequency of the angiotensin converting enzyme (ACE) gene polymorphism. On the other hand, heart failure has the capacity to create a physiological environment favourable to AF by contributing to atrial remodelling due to increased filling pressures, alterations in calcium handling and alterations to the electrical properties of the atrial tissue. Heart failure is associated with slower regional conduction and atrial fibrosis. In LV dysfunction, an elevated LV end-diastolic pressure leads to the increased left atrial pressure, which increases atrial wall stress resulting in changes in the renin angiotensin system, profibrotic and proinflammatory pathways. Left ventricular dysfunction is associated with the activation of several neurohormonal pathways, the most important of which is the pathological activation of the renin angiotensin system. This maladaptive system promotes myocyte hypertrophy, apoptosis, collagen deposition and interstitial remodelling, which all contribute to structural remodelling of the atria and the development of AF. Atrial fibrillation and heart failure share pathophysiological mechanisms and therefore frequently coexist. The major goals of the therapy in patients with AF are to prevent stroke, control the ventricular rate and reduce symptoms. These priorities are the same in patients with AF complicated by HF. Current data suggest that therapy strategy of the rhythm control is superior to the rate control, especially the rhythm control in HF with a catheter ablation. Although several clinical trials have shown that catheter ablation may lead to better outcomes, further studies in the future are needed.