The goal of clinical trial is to compare AF ablation to pharmacological rhythm management (being rate or rhythm control) in AF patients with signs of atrial cardiomyopathy (as defined by left atrial volume index \>34 ml/m2) The main objective it aims to answer is to determine whether AF ablation compared to pharmacological rhythm management in ACMP patients with AF reduces the incidence of the composite primary endpoint of CV death and first CV hospitalization/urgent visit.
Confirmed ACMP (LAVI >34 ml/m2)
ECG-confirmed AF
Age: 65-80 years old
Patients eligible for both treatment strategies judged by the treating physician signed and dated informed consent prior to admission to the trial
Longstanding (>1 year) persistent or permanent (accepted) AF
Previous left atrial (LA) ablation or LA surgery
AF due to a reversible cause (e.g. hyperthyroidism, post-operative AF)
Recent (<90 days) acute coronary syndrome, stroke/TIA or cardiac intervention (Cardiac interventions include percutaneous coronary intervention, coronary artery bypass grafting, and heart valve repair or replacement (endovascular or surgical))