Convergent Ablation Plus Left Atrial Appendage Isolation for the Treatment of Persistent Atrial Fibrillation

This study tests whether "convergent ablation" — combining a minimally invasive procedure inside the heart with one on the outside — along with isolating the left atrial appendage (a small pouch in the heart) can reduce or eliminate persistent atrial fibrillation (irregular heartbeat) better than current techniques alone. **You may be eligible if...** - You are an adult with persistent or long-standing persistent atrial fibrillation (AFib) that has not responded to prior treatments - You have failed at least one prior catheter ablation or are not a candidate for standard ablation alone - Your heart function is adequate for the procedure **You may NOT be eligible if...** - You have a blood clot in the heart's left atrial appendage - You have had recent major cardiac surgery - You have severe valve disease or other conditions making the procedure unsafe - You are pregnant Talk to your doctor to see if this trial is right for you.