Dual-Energy Lattice-Tip Assisted Marshall-Plan Strategy in Redo Persistent Atrial Fibrillation Ablation

This clinical trial will assess the efficacy and safety of a Marshall plan-based ablation strategy without ethanol infusion into the vein of Marshall in patients with persistent atrial fibrillation undergoing repeat ablation with a dual-energy lattice-tip catheter. Eligible participants will be randomized to receive either pulmonary vein re-isolation alone or pulmonary vein re-isolation plus the Marshall plan-based strategy. Patients who are found to have all pulmonary veins already isolated at the time of the procedure, or who are not suitable candidates for the Marshall plan-based approach, will be included in a separate observational cohort.