Renal Denervation Combined With Pulsed Field Ablation to Prevent Blanking-Period Recurrence in Persistent Atrial Fibrillation

Inclusion Criteria: * Age \> 18 years. * Patients with persistent atrial fibrillation undergoing first-time catheter ablation (defined as any episode lasting ≥7 days). * Symptomatic atrial fibrillation refractory to or intolerant of at least one class I or III antiarrhythmic drug and scheduled for guideline-directed catheter ablation. * Able to understand the study purpose, voluntarily participate, and sign the written informed consent form. Exclusion Criteria: * Presence of advanced structural heart disease. * Life expectancy \< 12 months. * Blood pressure \< 90/60 mmHg. * Pregnant or lactating women. * Anatomical abnormalities of the renal arteries unsuitable for treatment as determined by pre-procedural renal CTA. * History of renal artery intervention, impaired renal function with estimated glomerular filtration rate (eGFR) \< 45 mL/min/1.73 m² (calculated by the MDRD equation). * Secondary atrial fibrillation due to electrolyte imbalance, thyroid disorders, or other reversible or non-cardiac causes. * Contraindication to pulsed-field ablation (e.g., left atrial thrombus, prior atrial septal defect occluder implantation, or permanent metallic implant in the left atrium) or to anticoagulation therapy. * Known inability to obtain vascular access or contraindication to femoral venous puncture. * Heart failure with left ventricular ejection fraction \< 30% documented by transthoracic echocardiography within 3 months before ablation. * Patients with current or anticipated n…