Ultrasound-Based Renal Sympathetic Denervation as Adjunctive Upstream Therapy During Atrial Fibrillation Ablation

Inclusion Criteria: * Age ≥ 18 * Planned for a first-ever AF ablation procedure (paroxysmal or persistent); (prior to randomization, a technically successful AF ablation procedure, defined as involving pulmonary vein isolation, as well as bidirectional block of any attempted anatomic lesion sets such as cavotricuspid isthmus line, roofline, mitral line and superior vena cava isolation must have been completed) * History of hypertension and either: * Documented history of SBP ≥ 160 or DBP ≥ 100 (Stage III), or * Receiving ≥ 1 antihypertensive medication * Willingness to adhere to study restrictions and comply with all post-procedural follow-up requirements Exclusion Criteria: (if any of the following are YES, subject is not eligible) * Long-standing persistent AF (\> 12 months) * Individual with valvular AF or AF due to a reversible cause * Prior left atrial catheter or surgical ablation for an atrial arrhythmia (before this index procedure) * Prior left atrial surgery (such as mitral valve surgery or surgical ASD repair) * Prior treatment with other devices for hypertension including but not limited to ROX Coupler, Mobius stent and/or the CVRx barostimulator device * NYHA Class IV Congestive Heart Failure * Individual has renal artery anatomy that is ineligible for treatment (as determined by intra-procedural renal angiography). This includes: * Main renal artery diameter \< 3.0 mm or \> 8.0 mm * Main renal artery length \< 20 mm * Presence of renal artery ste…