Pulsed Field Ablation for the Treatment of Persistent Atrial Fibrillation: Pulmonary Vein Plus Superior Vena Cava Isolation Versus Pulmonary Vein Isolation Alone-A Prospective, Multicenter, Randomized Controlled Study

Inclusion Criteria: 1. Persistent atrial fibrillation (AFib) duration \< 1 year; 2. Age 18-75 years; 3. Willing to participate in this study, capable of understanding, and has signed the informed consent form; able to complete postoperative follow-up according to the protocol. Exclusion Criteria: 1. Significant cardiac dysfunction or structural abnormality: LVEF \< 50% or left atrial anteroposterior diameter \> 46 mm; 2. Previous left atrial ablation or cardiac surgery (including left atrial appendage closure); 3. Presence of permanent pacemaker, CRT, implantable cardiac monitor, or any type of ICD; 4. Previous pulmonary vein stent, pulmonary vein stenosis, or superior vena cava stenosis; 5. Previous unilateral phrenic nerve palsy; 6. Any prosthetic heart valve or moderate-to-severe (grade 3-4) valvular regurgitation/stenosis; 7. Any cardiac surgery, myocardial infarction, PCI/PTCA, or coronary stent implantation within 3 months prior to signing informed consent; 8. Unstable angina, NYHA class III/IV heart failure, primary pulmonary hypertension, rheumatic heart disease, or hypertrophic cardiomyopathy; 9. Thrombocytosis/thrombocytopenia, any disease contraindicating long-term anticoagulation, active systemic infection; 10. Atrial fibrillation due to reversible causes (e.g., hyperthyroidism); 11. Stroke or TIA within 6 months prior to signing informed consent; 12. Pregnant or lactating women; 13. Life expectancy \< 1 year; 14. Currently participating in or expected to participate in another drug/device/biologic clinical trial during the study period; 15. Intracardiac thrombus, drug or alcohol addiction, unwillingness or inability to complete follow-up; 16. Severe renal insufficiency (eGFR \< 30); 17. Previous catheter ablation for atrial fibrillation; 18. Primary severe sick sinus syndrome.