Atrial fibrillation (AF) is a heart condition where the heartbeat is irregular and often too fast. This happens when the upper chambers of the heart (the atria) beat out of sync with the lower chambers (the ventricles). If AF is not treated, it can cause blood clots to form in the heart. These clots can raise the risk of stroke, heart failure, or other serious problems.

Because of these risks, it’s important to treat AF, especially if it happens often or doesn’t go away on its own. One common treatment is called catheter ablation. In this procedure, a doctor places a thin, flexible tube (catheter) into a blood vessel and guides it to the heart. Heat or cold energy is then used to make small scars in heart tissue. These scars block the faulty signals that cause the heart to beat irregularly.

The most common area targeted during ablation is near the veins that bring blood from the lungs to the heart, called the pulmonary veins. This is known as pulmonary vein isolation (PVI).

While ablation can help many patients, AF sometimes comes back, and people may need the procedure again. Usually, doctors repeat the same treatment in the pulmonary veins.

This study is testing whether adding treatment to another area of the heart, called the posterior wall, can lead to better results. Patients in the study will be placed into one of two groups:

1. One group will receive ablation in the pulmonary veins only (PVI).
2. The other group will receive ablation in both the pulmonary veins and the posterior wall (PVI + PWI).

By comparing these two groups, we hope to learn whether treating both areas helps reduce AF and improve quality of life more effectively than treating the pulmonary veins alone.