New combo ablation aims to tame stubborn AFib

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Symptomatic patients with long-standing persistent atrial fibrillation. * Duration of atrial fibrillation between 1 and 3 years. * Age 18 to 75 years. * Documentation of atrial fibrillation within 3 years prior to enrollment. * Willing and able to comply with the study protocol and provide written informed consent. Exclusion Criteria: * Paroxysmal atrial fibrillation, or evidence of sinus rhythm on electrocardiogram within the past year. * Persistent atrial fibrillation lasting less than 1 year or more than 3 years. * Left atrial thrombus. * Prior catheter ablation for atrial fibrillation. * Coexisting severe organic heart disease (e.g., severe valvular heart disease, hypertrophic cardiomyopathy, dilated cardiomyopathy, etc.). * Left atrial diameter (LAD) \>55 mm. * Left ventricular ejection fraction (LVEF) \<40%. * Known allergy or contraindication to low-molecular-weight heparin, warfarin, or direct oral anticoagulants. * Undergoing a "one-stop" procedure combining atrial fibrillation ablation with left atrial appendage closure. * Allergy to alcohol or contrast media. * Pulmonary artery systolic pressure \>50 mmHg. * Unstable angina pectoris. * Percutaneous coronary intervention (PCI) within the past 3 months. * Cardiac surgery within the past 6 months. * Planned heart transplantation. * History of thromboembolic disease within the past 6 months (including venous thromboembolism: pulmonary embolism, deep vein thrombosis; or arterial thromboembolic disease: acute coronary syndrome, lower extremity arterial embolism, stroke). * Left atrial myxoma. * Severe respiratory disease. * Active infectious disease. * Poorly controlled or active systemic immune disease (equivalent to glucocorticoid use \>2 tablets/day). * Unresolved malignant hematologic disease, or currently receiving chemotherapy, radiotherapy, or immunotherapy. * Unresolved malignant solid tumor, or currently receiving chemotherapy, radiotherapy, or immunotherapy. * Untreated hypothyroidism or hyperthyroidism. * Severe hepatic insufficiency (alanine aminotransferase \[ALT\] or aspartate aminotransferase \[AST\] \>3 times the upper limit of normal). * End-stage renal failure requiring dialysis. * Other serious arrhythmias, such as hemodynamically unstable ventricular tachycardia. * Pregnancy or breast-feeding. * Psychiatric disorder. * Body mass index (BMI) \<18.5 or \>35.0 kg/m². * Life expectancy \<2 years.