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

Inclusion Criteria: * Patients aged 20 to 80 years who are candidates for catheter ablation for persistent atrial fibrillation * Patients eligible for catheter ablation according to existing clinical guidelines * Those without clinically significant structural heart disease (e.g., severe mitral regurgitation) * Those without contraindications to anticoagulation therapy Exclusion Criteria: * Atrial fibrillation associated with severe congenital heart disease or structural heart disease * Patients with contraindications to general anesthesia or sedation for the procedure * History of prior cardiac surgery (e.g., Maze procedure, coronary artery bypass grafting) * History of atrial fibrillation catheter ablation within the past 12 months * Patients with severe left ventricular dysfunction (left ventricular ejection fraction \<30%) * Patients with active internal bleeding * Patients with contraindications to anticoagulation therapy and antiarrhythmic drugs * Valvular atrial fibrillation (e.g., mitral stenosis \> grade 2, mechanical valve, prior mitral valve repair) * Patients with severe comorbid conditions * Patients with an expected survival of less than one year * Patients with drug or alcohol addiction * Pregnant or breastfeeding women * Any other conditions deemed by the investigator to make the patient unsuitable for study participation