This study is a prospective, multicenter, randomized, open-label, blinded end-point, controlled clinical trial to investigate the impact of first line pulsed field ablation during 12 months follow-up in patients with early-stage paroxysmal or persistent atrial fibrillation (\<3 years) compared to usual care, defined as OMT.
Adults (≥18 years) with symptomatic or asymptomatic, paroxysmal or persistent atrial fibrillation
First diagnosis of AF within the last 36 months
At least one documented episode of AF on ECG, Holter monitoring, or eligible Smart Watch Device
No prior catheter ablation for AF
Persistent AF >3 years or longstanding persistent AF
Previous AF-Ablation
Ongoing continuous AAD therapy with Amiodarone at baseline
History of failed continuous AAD therapy with > 1 agent. Exceptions are Beta blocker, Verapamil or "pill in the pocket"-therapy