A network meta-analysis of 16 randomized controlled trials including 5721 patients with heart failure and atrial fibrillation compared catheter ablation (CA), rhythm control (RhC), rate control (RC) and their combination (Rh + RC). Catheter ablation best improved left ventricular ejection fraction (MD = 0.34, 95% CI 0.17–0.50) and reduced BNP levels (MD = −0.56, 95% CI −0.72 to −0.39). CA significantly reduced all-cause mortality (OR = 0.58, 95% CI 0.42–0.80) and heart failure hospitalization (OR = 0.62, 95% CI 0.40–0.96) compared with the combined control. RhC and RC showed moderate efficacy, while Rh + RC significantly improved quality of life scores according to the MLHFQ questionnaire. No strategies differed significantly in adverse events, with a marginal advantage of Rh + RC according to SUCRA. The certainty of the evidence was moderate to high according to GRADE. The study recommends CA as the preferred option, considering the patient's comorbidities.