PVI Alone vs PVI With Posterior Wall Isolation for Pulse-Field Ablation in Persistent AF

To date, no optimal treatment has been established to improve outcomes in patients with persistent atrial fibrillation. The safety and efficacy of pulsed-field ablation (PFA) have been demonstrated in several studies, and its clinical application is expanding. \- In patients with persistent atrial fibrillation, can the addition of posterior wall isolation (PWI) following pulmonary vein isolation (PVI) using PFA reduce recurrence? Participants will: * Undergo either PVI alone or PVI with additional left atrial posterior wall isolation (PWI) * Visit the clinic to assess for recurrence of atrial tachyarrhythmias

NCT Number	NCT06929897
Lead Sponsor	Ewha Womans University Mokdong Hospital Collaborators: Ewha Womans University Seoul Hospital, Korea University Anam Hospital, Kangbuk Samsung Hospital, Asan Medical Center, Severance Hospital, Samsung Medical Center, Chonnam National University Hospital, Daegu Catholic University Medical Center
Conditions	Atrial Fibrillation (AF)
Enrollment	482 participants
Start Date	2026-07-03
Primary Completion	2029-06-30 (estimated)
Study Completion	2029-12-31 (estimated)
Updated on ClinicalTrials.gov	2026-07-16