A new Cleveland Clinic-led study shows ablation can be more effective than medication for people with persistent atrial fibrillation (AFib). The study found starting with ablation reduced irregular heart rhythm episodes and improve rhythm control—especially for patients with advanced disease. The study enrolled 388 patients, with 310 patients randomly assigned to ablation or medication. After one year, over half of the patients treated with pulsed field ablation stayed free from major AFib episodes. Nearly one-third of patients treated with medication alone saw the same results. The study was presented at the Heart Rhythm Society’s annual meeting in Chicago and simultaneously published in The New England Journal of Medicine. Atrial fibrillation is the most common type of heart rhythm disorder, with at least 2.7 million Americans living with it. Persistent AFib is defined as a continuous episode lasting more than 7 days. It affects up to 50% of patients with AFib. “These latest results show that we are continuing to move the needle in terms of treatment since persistent atrial fibrillation patients are typically sicker and have more profound effects of the disease.” said Dr. Oussama Wazni, M.D., section head of electrophysiology and pacing at Cleveland Clinic and principal investigator of the study #HRS2026