Safety and Efficacy of Pulmonary Vein Isolation Using Pulsed-field Ablation (PFA) Combined with Either PFA-based Left Atrial Posterior Wall Isolation or Vein of Marshall Ethanol Ablation in Patients with Persistent Atrial Fibrillation

Safety and Efficacy of Pulmonary Vein Isolation Using Pulsed-field Ablation (PFA) Combined with Either PFA-based Left Atrial Posterior Wall Isolation or Vein of Marshall Ethanol Ablation in Patients with Persistent Atrial Fibrillation

This study is designed to directly compare the safety and efficacy of PFA-based PVI+PWI vs PFA-based PVI+ VoM alcohol ablation in patients with Persistent AF.

Inclusion Criteria:

• Symptomatic persistent AF; 1st or redo ablation with PVI-only in the earlier procedure
• Willing to provide informed consent
• Age: 18-85 years

Exclusion Criteria:

• • Previous PWI or VoM ablation procedure

  • Left ventricular ejection fraction <40%
  • Left atrial thrombus
  • Myocardial infarction within last 60 days
  • Cardiac surgery in the last 6 months
  • Advanced renal failure
  • Life expectancy <1 year
  • Pregnant women
  • Unable or unwilling to provide informed consent