Inclusion Criteria:
- Male or female between 18 and 80 years of age
- Willing and able to comply with the study protocol, provide a written informed consent
- History of Atrial Fibrillation in past 12 months
- Indicated to undergo an acute electrophysiology procedure allowing for conscious participation in the clinical study
- Current treatment and compliance with standard anticoagulation regimen, including uninterrupted OAC, with acceptable coagulation status, as determined by the Principal Investigator
Study stage dependent: Stage 1:
6a. History of DC-Cardioversion in past 12 months: With or Without
7b. AFEQT Score: <=89
Study stage dependent: Stage 2 (based on results from study stage 1):
6a: History of DC-Cardioversion in past 12 months: Potential emphasis on patients with history of DCCV
7b. AFEQT Score: Potential emphasis on patients with AFEQT <= 58
Exclusion Criteria:
- Life expectancy of 1 year or less
- AF due to reversible causes (e.g., hyperthyroidism, valve disease)
- Hx of fibromyalgia or any other evidence of wide-spread pain
- Any current pain condition that could be confused with pain or discomfort associated with MPT
- >1 current well-defined pain condition (e.g., migraine, joint OA, painful diabetic neuropathy)
- Use of any opioid analgesic (including tramadol) within 3 months of screening
- Spielberger's STAI-AD-Trait > 75
- AFEQT: Section 1: "I was never aware of having atrial fibrillation" is checked
- Allergy or contraindication to anticoagulation therapy
- Presence of intracardiac thrombus (confirmed with cardiac imaging)
- Existing Left Atrial Appendage closure device
- LVEF<20%
- NYHA Class IV heart failure at the time of enrollment
- History of embolic stroke, Transient Ischemic Attack (TIA) or other thromboembolic event within the preceding 3 months.
- Known hyper-coagulable state that increases risk of thrombus
- History of myocardial infarction or coronary revascularization within the preceding 3 months.
- History of sustained ventricular arrhythmia or cardiac arrest
- Presence of chronically implanted lead in the CS
- Presence of ventricular assist device, including intra-aortic balloon pump
- Documented bradycardia (<40 BPM) at the time of the study
- Morbid obesity: BMI>39 kg/m2
- Presence of any prosthetic cardiac valve
- History of significant tricuspid valvular disease requiring surgery
- Moderate to severe mitral valve regurgitation (>40% regurgitation fraction)
- Cognitive or mental health status that would interfere with study participation and proper informed consent
- Cardiovascular anatomical defects that would complicate placement of the stimulation leads required by the protocol, including congenital heart disease and cardiac vein anomalies per the Investigator's discretion
- Pregnancy confirmed by test within 7 days of procedure.
- Inability to pass catheters to heart due to vascular limitations
- Cardiovascular surgery or intervention within 1 month prior to enrollment or planned for up to 1 month after enrollment (other than the planned treatment procedure)
- Active endocarditis
- History of hemodynamic compromise due to valvular heart disease
- Unstable CAD as determined by the investigator
- Severe proximal three-vessel or left main coronary artery disease without revascularization as determined by the investigator
- History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis
- Any other medical condition which may affect the outcome of this study or safety of the subject as determined by the investigator