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Background: Catheter ablation is an important rhythm control therapy in patients with atrial fibrillation (AF) with concomitant heart failure (HF). The objective of this study was to assess the comparative efficacy of AF ablation patients with ischemic vs nonischemic heart failure., Methods: We conducted a retrospective, observational cohort study of patients with HF who underwent AF ablation. Outcomes were compared based on HF etiology and included in-hospital events, symptoms (Mayo AF Symptom Inventory [MAFSI]), and functional status (New York Heart Association class) and freedom from atrial arrhythmias at 12 months., Results: Among 242 patients (n = 70 [29%] ischemic, n = 172 [71%] nonischemic), patients with nonischemic cardiomyopathy were younger (mean age 64 ± 11.5 vs 69 ± 9.1, P  = .002), more often female (36% vs 17%, P  = .004), and had higher mean left-ventricular ejection fraction (47% vs 42%, P  = .0007). There were no significant differences in periprocedural characteristics, including mean procedure time (243 ± 74.2 vs 259 ± 81.8 minutes, P  = .1) and nonleft atrial ablation (17% vs 20%, P  = .6). All-cause adverse events were similar in each group (15% vs 17%, P  = .7). NYHA and MAFSI scores improved significantly at follow-up and did not differ according to HF etiology ( P  = .5; P  = .10-1.00 after Bonferroni correction). There were no significant differences in freedom from recurrent atrial arrhythmia at 12-months between ischemic (74%) and nonischemic patients (78%): adjusted RR 0.63, 95% confidence interval 0.33-1.19., Conclusions: Catheter ablation in patients with AF and concomitant heart failure leads to significant improvements in functional and symptom status without significant differences between patients with ischemic vs nonischemic HF etiology., Competing Interests: E. Black‐Maier: None. BA Steinberg: Fellowship Support; Medtronic, Inc, St. Jude Medical, Biotronik, Boston Scientific Corp. Fellowship Support; Biosense Webster, Inc.; Boston Scientific Corp., Janssen Pharmaceuticals. Other; Bristol Meyers Squibb. K. Trulock: None. F. Wang: None.. Y. Lokhnygina: None. W. O 'Neal: None. SM Al‐Khatib: None. BD Atwater: Research Grants; St. Jude Medical. JP Daubert: consulting fees/honoraria from Medtronic, St. Jude Medical, Boston Scientific, Sorin Group, and CardioFocus' research grants from Boston Scientific, Biosense Webster, Medtronic, and Gilead Sciences. C. Frazier‐M ills: None. DD Hegland: None. KP Jackson: None. LR Jackson: None. JI Koontz: None. RK Lewis: None. AY Sun: None. KL Thomas: None. TD Bahnson: Research Grants: Medtronic; St. Jude Medical; Consultant to Boehringer Ingelheim, ChanRX, Sequel Pharma, and Sanofi‐Aventis. JP Piccini: research grants from Abbott, American Heart Association, Bayer, Boston Scientific, Gilead, Janssen Pharmaceuticals, NHLBI, and Philips and consultant fees from Abbott, Allergan, ARCA Biopharma, Biotronik, Boston Scientific, Johnson & Johnson, LivaNova, Medtronic, Milestone, Sanofi, and Philips., (© 2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.)