Heart Failure Progression in the Setting of Persistent Atrial Fibrillation, Frequent Premature Ventricular Complexes, and Malignancy-Related Limitations to Guideline-Directed Medical Therapy: A Case Report

Persistent atrial fibrillation and frequent premature ventricular complexes may contribute to worsening heart failure, particularly when malignancy limits guideline-directed medical therapy. In patients with progressive ventricular dysfunction and limited pharmacologic options, atrioventricular nodal ablation with cardiac resynchronization therapy-defibrillator implantation may provide durable rate control and support subsequent ventricular functional recovery.