The purpose of this prospective randomized study is to assess whether a new treatment strategy consisting of circumferential Pulmonary vein isolation (PVI), left ROof linear (RL), Mitral Isthmus linear (MIL), and left anterior SEptal linear (ASL) ablation and left atrial appendage (LAA) Device occlusion (PROMISED procedure) is superior to the PVI combined LAA closure in enhancing the long-term success rate of catheter ablation in non-paroxysmal atrial fibrillation (AF) patients.
Age > 18 years;
Persistent AF (AF duration > 7 days);
CHA2DS2-VASc score ≥2;
Unsuitable for long-term standardized anticoagulation therapy;
Previous atrial fibrillation ablation
Transthoracic echocardiography suggests that the anteroposterior diameter of the left atrium is greater than 60 mm;
persistent AF that lasts >10 years
Scheduled cardiac surgical intervention.