CPVI With Modified Linear Ablation Versus CPVI in Patients With Long-standing Persistent Atrial Fibrillation (SINUS)

Inclusion Criteria: 1. 1\. Patients with symptomatic LSPAF refractory to at least one antiarrhythmic drug; LSPAF will be defined as a sustained AF episode lasting ≥ 1 year; 2. AF duration 1-3 years; 3. Age 18 - 75 years; 4. Left atrial diameter (LAD) 43-55 mm on long axis parasternal view; 5. AF recorded within 3 years of enrollment; 6. Patient willing and able to comply with protocol and sign informed consent Exclusion Criteria: 1. Paroxysmal atrial fibrillation; 2. Persistent AF lasting \< 1 year or \>3 years; 3. Left atrial thrombosis; 4. Patients with a history of catheter ablation for AF; 5. Patients with severe structural heart disease (severe valvular heart disease, hypertrophic cardiomyopathy, dilated cardiomyopathy, etc.); 6. LAD \> 55mm on long axis parasternal view; 7. Left ventricular ejection fraction (LVEF) \< 40%; 8. Patients with contraindications to low molecular weight heparin, warfarin or novel oral anticoagulants; 9. One-stop procedure for AF ablation and left atrial appendage occlusion; 10. Alcohol allergy or contrast agent allergy; 11. Patients taking cephalosporin antibiotics within 72 hours prior to ablation; 12. Pulmonary artery systolic pressure \> 50mmHg; 13. Patients with unstable angina pectoris; 14. Patients who had undergone percutaneous coronary intervention (PCI) within 3 months; 15. Patients who had undergone surgery within 6 months; 16. Patients ready to receive heart transplantation; 17. Patients with a history of thromboembolism within 6 months; 18. Patients with diagnosed atrial myxoma; 19. Patients with severe respiratory diseases; 20. Patients with infectious diseases in active phase; 21. Patients with poorly controlled systemic immune diseases; 22. Patients with uncured malignant hematological diseases; 23. Patients with uncured malignant solid tumors; 24. Patients with untreated hypothyroidism or hyperthyroidism; 25. Patients with severe liver dysfunction (elevation of transaminases \[ALT or AST\] \>3 times the upper limit of normal range); 26. Patients with end-stage renal failure requiring dialysis; 27. Patients with other serious arrhythmias, such as ventricular tachycardia with hemodynamic instability; 28. Pregnant and lactating women; 29. Patients with psychiatric ailments; 30. BMI \< 18.5 or ≥ 30kg/m2; 31. Life expectancy \< 2 years; 32. Patients unwilling or unable to give informed consent; 33. Patients unwilling or unable to cooperate to complete follow-up.