Assessment of Pulmonary Vein Isolation Using a Balloon Catheter With Pulsed Field Energy in Atrial Fibrillation

Inclusion Criteria: * Paroxysmal or persistent atrial fibrillation documented on a 12 lead electrocardiogram or Holter monitor (lasting ≥30 seconds) within the last 24 months. * Candidate for ablation based on current AF guidelines * Continuous anticoagulation with Vitamin-K-Antagonists or a non-vitamin K antagonist anticoagulant (NOAC) for ≥4 weeks prior to the ablation; or a transesophageal echocardiogram (TEE) and/or computed tomography (CT) that excludes left atrial thrombus ≤48 hours before ablation * Age of 18 years or older on the date of consent * Informed consent as documented by signature Exclusion Criteria: * History of left atrial (LA) ablation or surgery involving the LA * Persistent atrial fibrillation (AF) lasting longer than 12 months * AF resulting from temporary or reversible causes * Presence of thrombus within the heart chambers * Prior pulmonary vein (PV) stenosis or stenting * Existing paralysis of one side of the diaphragm * Known allergy or contraindication to anticoagulant medication or contrast agents * History of mitral valve surgery * Significant mitral valve disease * Myocardial infarction occurring within three months prior to informed consent * Current use of triple antithrombotic therapy * Cardiac surgery within the past three months or a scheduled cardiac surgery or TAVI * Major congenital heart abnormalities * Congestive heart failure classified as NYHA class III or IV * Left ventricular ejection fraction (LVEF) less than 35% * Diagnosed hypertrophic cardiomyopathy (wall thickness exceeding 1.7 cm) * Severe chronic kidney disease (eGFR below 30 ml/min) * Uncontrolled hyperthyroidism * Stroke or transient ischemic attack (TIA) within three months before consent * Active systemic infections * History of cryoglobulinemia * Diagnosed cardiac amyloidosis * Current pregnancy * Estimated life expectancy under one year, as judged by the treating physician * Enrollment in another clinical study that may interfere with this trial's outcomes * Inability or unwillingness to adhere to study requirements and follow-up visits