LAA Clipping Versus NOACs to Prevent Stroke in Non-paroxysmal Atrial Fibrillation.

Inclusion Criteria: * Age ≥ 18 years. * Persistent or long-standing persistent AF documented by medical history or direct electrocardiogram. * CHA2DS2-VASc ≥2 in men and ≥3 in women. * Agree to perform thoracoscopic LAA occlusion procedure. Exclusion Criteria: * With electrical cardioversion or ablation intent. * Other heart diseases with surgical indications. * Ischemic stroke and other cardiac embolic events within 30 days. * Major clinical bleeding event within 30 days. * Contraindications to anticoagulation. * Intracardiac thrombus. * Left ventricular ejection fraction (LVEF) \< 30%. * Active systemic infection or infective endocarditis or pericarditis * Severe liver disease (acute clinical hepatitis, chronic active hepatitis, cirrhosis) or alanine transaminase (ALT)/ aspartate transaminase (AST) greater than 3 times the upper limit of normal value. * Severe renal insufficiency (eGFR ≤ 30mL/min). * Other diseases requiring oral anticoagulants. * Active aortic plaque. * Acute coronary syndrome within 3 months. * Symptomatic carotid artery stenosis. * Patients requiring dual antiplatelet drug therapy. * Previous cardiac and left lung surgery. * Severe left pleural and pericardial adhesions. * Pregnant or breastfeeding patients. * Metal allergies. * Terminal illness with a life expectancy of less than 2 years. * Participation in other clinical studies at the time of enrollment. * Refuse to participate in this study.