Ablation Versus Medical Management of Atrial Fibrillation in HFpEF

Inclusion Criteria: * between 18 to 90 years of age, male or female * Left Ventricular Ejection Fraction (LVEF) \> 50% by echocardiogram during routine screening or within 12 months prior to enrollment day. * Symptoms of heart failure requiring treatment with diuretic therapy for at least 30 days preceding enrollment. * Symptomatic paroxysmal or persistent atrial fibrillation. * Paroxysmal atrial fibrillation defined as recurrent AF (at least 2 episodes) that terminated spontaneously within 7 days * Persistent AF was defined as AF which is sustained beyond 7 days, or lasting less than 7 days but necessitating pharmacologic or electrical cardioversion * Included within the category of persistent AF is "long-standing persistent AF" defined as continuous AF of greater than 1 year in duration * AF episodes had to be documented in the last 3 months prior to enrollment by ECG, Holter monitor, Loop recorder, memory of the implanted device, or any suitable device. * Current symptoms of heart failure (NYHA II-IV) at the enrollment visit (Visit 1) * Structural heart disease evidenced by one or both of the following echocardiographic findings (done during the transthoracic echocardiography (TTE) within 6 months of enrollment) * Left atrial enlargement (LAE) defined as LA width \> 3.8 cm or LA length \> 5.0 cm, or LA area \> 20 cm2 or LA volume \> 55 mL or LA volume index \> 29 ml/m2. (of note, LA length greater than 6.0 cm will be excluded) * Left ventricular hypertrophy (LVH) defined …