2.1 | Study population
This prospective study registered at the Chinese Clinical Trial Registry
(ChiCTR2300068980) was conducted in accordance with the principles
outlined in the Helsinki Declaration and approved by the ethics
committee of Beijing Anzhen Hospital. Informed written consent was
obtained from all participants before enrollment. Patients with
drug-refractory PeAF undergoing their initial PFA procedure at Beijing
Anzhen Hospital were prospectively enrolled. The study flowchart is
depicted in Figure 1. The inclusion and exclusion criteria were as
follows. Inclusion criteria: 1) Age over 18 years and less than 80
years; 2) AF duration between 3 months to 3 years; 3) No previous
history of AF ablation; 4) Willingness to provide written informed
consent and participate in follow-up assessments; 5) Cardiac thrombus
excluded by transesophageal echocardiography or intracardiac
echocardiography. Exclusion criteria: 1) Previous history of AF
ablation; 2) Previous history of left LA surgery; 3) LA diameter
> 55mm; 4) Other serious heart disease, or other serious
arrhythmias except AF, atrial flutter (AFL) and atrial tachycardia (AT);
5) Contraindications for ablation, such as atrial thrombus, tumor,
infection, or other terminal illnesses.; 6) Significant bleeding event,
or can not tolerate anticoagulation therapy.