Inclusion Criteria:  Persistent AF (duration < 12 months) according to current ESC guideline (2020) Symptoms EHRA classification II - IV Age ≥ 75 years Capability of giving written informed consent  Exclusion Criteria:  impaired systolic left ventricular function (ejection fraction < 50%) High-grade (III°) left cardiac valvular disease pre-implanted pacemaker bradycardia-indication for pacemaker Surgical coronary revascularization (within the last 90 days) or current triple therapy after stent PCI contraindication for PVI or pacemaker-implantation contraindication for oral anticoagulation body-mass-index BMI > 35 kg/m2 inability to give written informed consent concomitant participation in another registered trial life expectancy < 12 months reversible cause of AF (e.g. thyrotoxicosis, alcohol ingestion)