Reversal of Atrial Substrate to Prevent Atrial Fibrillation Cohort Study

This observational study follows patients with irregular heart rhythm (atrial fibrillation, or AF) who have additional risk factors like obesity, high blood pressure, or diabetes. Participants undergo ablation (a procedure to correct the heart's electrical signals) along with lifestyle or medical changes. The study tracks whether these combined approaches reduce AF over time. **You may be eligible if...** - You have symptomatic atrial fibrillation despite rate control medication - You have paroxysmal or persistent AF and want catheter ablation - You have a BMI of 30 or higher, OR have at least two risk factors such as obesity, high blood pressure, diabetes, heart failure, age 65+, prior stroke, smoking, or excess alcohol use - You received catheter ablation between November 2019 and December 2025 - You declined or were not offered enrollment in the main RASTA-AF study **You may NOT be eligible if...** - You do not have symptomatic AF - You did not undergo catheter ablation during the study period Talk to your doctor to see if this trial is right for you.