Concomitant Hybrid Versus Catheter Ablation for Atrial Fibrillation With Hypertrophic Cardiomyopathy

Inclusion Criteria: Patients' age is ≥18 y Clinically diagnosed hypertrophic cardiomyopathy (any left ventricular wall segment thickness ≥15 mm in genetical negative (or unknown genetical status) patients or ≥13mm in genetical positive ones-as measured by any imaging technique (echocardiography, cardiac magnetic resonance imaging or computed tomography)-that is not explained solely by loading conditions) Non-obstructed left ventricular outflow obstruction with peak gradients <30mmHg Concomitant with persistent atrial fibrillation (7 days<sustained episode lasting<3 years) with drug-refractory symptoms. Be able to understand the contents of the trial, and provide written informed consent to participate in this investigation. Exclusion Criteria: Patients with left atrial size >60 mm (2-dimensional echocardiography, parasternal long-axis view) Contraindicated to systemic anticoagulation Left ventricular ejection fraction ≤40% Concomitant with left atrium or left atrial appendage emboli Concomitant with severe mitral or tricuspid regurgitation Concomitant with coronary artery disease or valvular disease that needs open heart surgeries Ischaemic stroke within 2 months Previous ablation history Uncontrolled hyper/hypothyroidism End-staged kidney failure Concomitantly involved in other trials Pregnant or breastfeeding, or women of childbearing age not using a reliable contraceptive method Concomitant with bacteremia or at an active phase of infection Anatomically not suitable for thoracoscopic surgery(history of chest surgery or radiotherapy, etc.) Unwilling or unable to comply with all peri-ablation and follow-up requirements