Cardioneuroablation vs Pulmonary Vein Isolation in Treatment of Paroxysmal Atrial Fibrillation

Inclusion Criteria: Paroxysmal atrial fibrillation documented in ECG or Holter monitoring Deceleration capacity >7.5ms Life expectancy more than 1 year Age ≥18 years Exclusion Criteria: Permanent AF lasting more than one year or persistent AF lasting more than 7 days AF secondary to electrolyte imbalance, thyroid disease, alcohol abuse, or other non-heart related causes Anteroposterior dimension of the left atrium in the echocardiography ≥43mm Clinically significant arrhythmias other than AF Significant valvular disease Valve prosthesis Heart failure III or IV Class in New York Heart Association Classification Previous ablation of atrial fibrillation or atrial flutter History of a patent foramen ovale/atrial septal defect closure History of left atrial appendage closure Atrial myxoma Presence of a cardiac pacemaker, defibrillator or cardiac resynchronization therapy device History of pericarditis Congenital heart disease History of bleeding or coagulation disorders Contraindications to oral anticoagulation Contraindications to computed tomography or magnetic resonance imaging Pregnancy or breast-feeding BMI>31 History of transplantation Severe lung disease Chronic renal failure defined as estimated glomerular filtration rate (eGFR) <30 mL/min/m2 Cancer Significant infection Life expectancy less than one year Mental disorders Lack of informed consent to participate in the trial