There is no consensus regarding optimal methodology for blood pressure monitoring in patients with a depressed ejection fraction undergoing catheter ablation for atrial fibrillation. Our goals were to determine if hemo dynamic management differences exist during radiofrequency ablation for atrial fibrillation in patients with and without an ejection fraction< 50%, and whether management was influenced by the utilization of invasive arterial blood pressure monitoring. This single-center trial retrospectively compared blood pressure management during catheter ablation of atrial fibrillation in all patients with an ejection fraction< 50% over a 2-year span (n=44), and compared to an age-matched cohort with preserved ejection fraction ablated over the same span in time (n=44). Blood pressure was not significantly managed differently between the groups and did not appear to be influenced by the use of invasive arterial blood pressure monitoring. Hemodynamic management is similar across the spectrum of ejection fraction, regardless of invasive arterial blood pressure monitoring, which challenges the need for invasive arterial blood pressure monitoring during catheter ablation of atrial fibrillation in left ventricular systolic dysfunction