Background

Persistent atrial fibrillation (AF) is associated with increased morbidity, mortality, stroke risk, heart failure, and reduced quality of life. Catheter ablation has emerged as an effective rhythm-control strategy; however, outcomes in persistent AF remain less favorable than in paroxysmal AF due to advanced atrial remodeling and complex arrhythmogenic substrates.

Objective

To evaluate procedural success, arrhythmia recurrence, quality-of-life improvement, and long-term clinical outcomes following catheter ablation in patients with persistent AF.

Methods

A prospective multicenter study enrolled 600 consecutive patients with persistent AF undergoing catheter ablation between January 2020 and December 2024. Clinical, procedural, and follow-up data were collected over a 24-month period. Primary endpoints included freedom from atrial arrhythmia recurrence, symptom improvement, hospitalization, stroke, and mortality.

Results

Pulmonary vein isolation (PVI) was successfully achieved in 98.5% of patients. At 12 months, freedom from atrial arrhythmia recurrence was 72.8%, increasing to 82.1% after repeat procedures. Significant improvements were observed in symptom burden, exercise capacity, and quality of life. Major complications occurred in 3.2% of patients.

Conclusion

Catheter ablation provides effective rhythm control and substantial clinical improvement in patients with persistent AF. Contemporary ablation techniques achieve high procedural success with acceptable complication rates and meaningful long-term benefits.