Cyroablation for Pulmonary Vein Isolation Alone in Patients With Early Persistent AF Assessed by Continuous Monitoring

Inclusion Criteria: * Drug refractory symptomatic persistent atrial fibrillation diagnosed within 3 years * Either two conditions 1. atrial fibrillation episode lasting longer than 7 days, but less than 3 years documented by consecutive electrocardiogram recordings of 100% atrial fibrillation greater than 7 days apart or 2. atrial fibrillation episode requiring electrical or pharmacological cardioversion after 24 hours of atrial fibrillation documented by continuous recording * Willing to comply with study requirements and give informed consent to participate in this clinical study Exclusion Criteria: * Long-standing persistent atrial fibrillation more than 3 years * Sinus rhythm at enrollment * Recurrent sinus rhythm after electrical cardioversion * Severe left ventricular dysfuncion (left ventricle ejection fraction \< 30%) * Previous ablation procedure or surgery for atrial fibrillation * Contraindication to chronic anticoagulation therapy or heparin * Documented left atrial diameter \>50 mm from parasternal long-axis view * A percutaneous coronary intervention or myocardial infarction ≤3 months * A stroke or transient ischemic attack ≤6 months * Planned cardiovascular intervention * Mental or physical inability to participate in the study * Participation in another randomized clinical trial * Uncontrolled hypertension, untreated hypothyroidism or hyperthyroidism * Requirement for dialysis due to terminal renal failure