Pulsed Field Ablation for the Treatment of Persistent Atrial Fibrillation: pulmonary Vein Plus Superior Vena Cava Isolation Versus Pulmonary Vein Isolation Alone-A Prospective, Multicenter, Randomized Controlled Study

his study is for people aged 18 to 75 who have persistent atrial fibrillation (AFib) thathas lasted less than one year and who are having their first catheter ablation procedure.Atrial fibrillation is a common heart rhythm problem. A standard treatment is a catheterprocedure called pulmonary vein isolation (PVI), which uses energy to disconnect thepulmonary veins from the rest of the heart. However, in persistent AFib, the heart rhythmoften returns after PVI alone.Some people also have abnormal electrical signals coming from a large vein above theright atrium called the superior vena cava (SVC). This study tests whether adding SVCisolation (SVCI) to the standard PVI procedure works better than PVI alone.The study will use pulsed field ablation (PFA), a newer non‐heating technology thattargets heart muscle cells and may cause less damage to nearby structures such as thefood pipe and nerves.About 340 participants will be enrolled from around 10 hospitals in China. Using acomputer process, half will be assigned to PVI alone and half to PVI plus SVC isolation.Neither the doctor nor the participant will be blinded to the group assignment becausethe difference between the two procedures is visible.All participants will be followed for 12 months after the procedure. The main questionis: after a 3‐month healing period, how many people stay free from AFib and other atrialrhythm problems for the remaining 9 months without needing more ablation or new rhythmmedicines? The study also looks at safety, quality of life, hospital stays, and whetherthe heart rhythm returns.