Why is first-time catheter ablation of persistent atrial fibrillation less successful than paroxysmal atrial fibrillation? Patients with atrial fibrillation are concerned about what to do if they have atrial fibrillation. As we have discussed many times before, catheter ablation is the only way to cure AF. However, it should be emphasized that not all atrial fibrillation can be ablated successfully. For example, the first ablation of paroxysmal AF is more effective than that of persistent AF because the pathogenesis of persistent AF is more complex, i.e., when paroxysmal AF is transformed into persistent AF, there are more and wider atrial foci involved in the atrial fibrillation, which is complex. Therefore, the success rate of catheter ablation for paroxysmal atrial fibrillation is higher, but for persistent atrial fibrillation, the success rate is comparable to that of paroxysmal atrial fibrillation if ablation is performed again. Even so, we still want to treat patients in the paroxysmal phase so that doctors don’t have too much trouble treating them and patients can achieve the desired outcome.