Clinical Research Directory

Inclusion Criteria: * One or more prior left atrial (LA) ablation procedure(s) for AF * Symptomatic AF/atypical atrial flutter/atrial tachycardia with failure of or intolerance to medical rate or rhythm control therapy, that is detected at \>2 months post most recent LA ablation procedure * Either a LA volume index on any prior echo of \>= 45ml/m2 or LA diameter \>= 50mm OR a HATCH score \>=2 (where 1 point is given for each for hypertension, Age\>75, COPD, and 2 points for each of stroke/TIA, or HF (defined as signs or symptoms of pulmonary edema and may include HFrEF or HFpEF) * Be considered suitable for both treatment strategies of redo ablation and pacemaker and AV node ablation * Willingness to participate, complete the QOL questionnaires and ability to sign informed consent Exclusion Criteria: * Severe valvular disease defined by echo criteria * Myocardial infarction, stroke, or coronary revascularization within the previous 3 months * LVEF \<40% or need for an ICD * Life expectancy \<24 months * Lack of capacity to consent