Pulsed Field Ablation Versus Radiofrequency Ablation for Persistent Atrial Fibrillation

Inclusion Criteria: * 18-80 years * Patients with non-valvular persistent atrial fibrillation undergoing their first catheter ablation (AF duration: 3 months to 3 years) * Left atrial diameter on parasternal long-axis view of echocardiogram \< 50 mm * Agree to be randomly assigned to the ablation strategy and able to follow up Exclusion Criteria: * Atrial fibrillation due to reversible causes * LVEF \< 30% * Severe congenital heart disease * Severe liver or kidney dysfunction (eGFR \< 15, Child-Pugh grade 3), or history of dialysis * History of cardiac surgery, such as coronary artery bypass grafting, mechanical valve or prosthetic valve replacement * History of pacemaker implantation, left atrial appendage closure, or patent foramen ovale closure * Contraindications to oral anticoagulation * Contraindications to right or left heart catheterization * Pregnancy * Life expectancy \< 1 year (e.g., advanced malignancy, end-stage renal disease) * Currently enrolled in another trial evaluating medical devices or drugs * Other situations where the investigator determines the subject is unsuitable for the study