To date, no optimal treatment has been established to improve outcomes in patients with persistent atrial fibrillation. The safety and efficacy of pulsed-field ablation (PFA) have been demonstrated in several studies, and its clinical application is expanding.
\- In patients with persistent atrial fibrillation, can the addition of posterior wall isolation (PWI) following pulmonary vein isolation (PVI) using PFA reduce recurrence?
Participants will:
* Undergo either PVI alone or PVI with additional left atrial posterior wall isolation (PWI) * Visit the clinic to assess for recurrence of atrial tachyarrhythmias
Patients eligible for catheter ablation according to existing clinical guidelines
Those without clinically significant structural heart disease (e.g., severe mitral regurgitation)
Those without contraindications to anticoagulation therapy
Atrial fibrillation associated with severe congenital heart disease or structural heart disease
Patients with contraindications to general anesthesia or sedation for the procedure
History of prior cardiac surgery (e.g., Maze procedure, coronary artery bypass grafting)
History of atrial fibrillation catheter ablation within the past 12 months
Ewha Womans University Mokdong Hospital
Lead sponsor
Ewha Womans University Seoul Hospital
Collaborator
Korea University Anam Hospital
Collaborator
Ajou University School of Medicine
Collaborator
Seoul National University Bundang Hospital
Collaborator
Kangbuk Samsung Hospital
Collaborator
Hanyang University Seoul Hospital
Collaborator
Asan Medical Center
Collaborator
Wonkwang University Hospital
Collaborator
Korea University Guro Hospital
Collaborator
Severance Hospital
Collaborator
Eunpyeong St. Mary's Hospital
Collaborator