Marshall Vein Ethanol Infusion in Addition to Pulsed Electric Field Ablation Versus Pulsed Electric Field Ablation Alone for Paroxysmal Atrial Fibrillation

This study is comparing two ablation techniques for people with paroxysmal atrial fibrillation (AF — a type of irregular heartbeat that comes and goes) who are having their first ablation procedure. It compares pulsed electric field (PEF) ablation alone versus PEF ablation combined with an injection of ethanol (alcohol) into a vein near the heart called the Marshall vein, which may improve long-term results. **You may be eligible if...** - You are over 18 years old - You have symptomatic paroxysmal AF (episodes that last less than 7 days and cause symptoms like palpitations, dizziness, or shortness of breath) - You have had at least one documented AF episode in the past 12 months - This is your first AF ablation procedure **You may NOT be eligible if...** - Your AF is persistent (lasting more than 7 days) rather than paroxysmal - You have a blood clot in the heart - You have a contraindication to blood thinners (e.g., history of heparin-induced thrombocytopenia) - Your AF is caused by a reversible cause (e.g., thyroid disease or electrolyte imbalance) - You had a heart attack or coronary procedure in the past 3 months - You had a stroke or TIA in the past 3 months - You have had prior heart surgery involving the left atrium, or you have severe valve disease, hypertrophic cardiomyopathy, or a very large left atrium - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.