Objective To explore the effect of catheter ablation combined with PCI on the prognosis of patients with atrial fibrillation and coronary artery disease compared with PCI alone. Methods Patients with atrial fibrillation and coronary artery disease who were hospitalized in Tai'an Central Hospital from January 2018 to December 2022 were divided into PCI group (n=86) and ablation +PCI group(n=32) according to interventional treatment measures. The basic clinical data, coronary artery lesion characteristics and PCI intervention data of the above patients were collected. Adverse events such as ischemic stroke, acute coronary events, heart failure, recurrent paroxysmal atrial fibrillation, recurrence of atrial fibrillation after catheter ablation, bleeding events and the above composite endpoint events were recorded within 12 months after operation. Results There was no significant difference in the basic clinical data, the characteristics of coronary artery lesions and PCI intervention between the two groups (P>0.05). The incidence of heart failure events and compound endpoint events in PCI group was significantly higher than that in RF +PCI group (P<0.05). The Kaplan -Meier survival curves of the two groups were compared, and the difference was statistically significant (χ2=3.940,P=0.047). Conclusion Catheter ablation combined with PCI can reduce the incidence of heart failure and compound adverse events in patients with atrial fibrillation and coronary artery disease and improve the prognosis of the patients