Inclusion Criteria:  Age 65-89 Paroxysmal or persistent symptomatic AF refractory to antiarrhythmic drugs. Failure from the previous catheter ablation of AF, or contraindicate /unwilling to undergo catheter ablation. Dual chamber pacemaker implanted Understands the nature of the study, treatment procedure and provides written informed consent Willing to comply with specified pre-, post- and follow-up testing, evaluations and requirements  Exclusion Criteria:  Permanent AF Unstable angina Presence of any disease that is likely to shorten life expectancy to < 1 year Any cardiac surgery within three months prior to enrolment Awaiting cardiac transplantation or other cardiac surgery within the next year Myocardial infarction (MI) within 60 days prior to enrolment Contraindications to oral anticoagulation Active systemic infection or sepsis History of a documented thromboembolic event such as stroke or transient ischemic neurological attack (TIA) in the three months prior to enrollment. Any other clinical condition that might jeopardize patient safety during participation in this trial or prevent the subject from adhering to the trialprotocol Esophageal ulcer.