CONVERGE Post-Approval Study (PAS)

Inclusion Criteria:

1. Age ≥ 18 years and < 80 years at time of enrollment consent;

2. Left atrium ≤ 6.0 cm assessed with Transthoracic Echocardiography [TTE] withparasternal 4 chamber view or equivalent imaging modality;

3. Refractory or intolerant to at least one AAD (class I and/or III);

4. Subject has symptomatic (e.g. palpitations, shortness of breath, fatigue)longstanding persistent atrial fibrillation as defined by the 2017 HRS/EHRA/ECASGuidelines (> 12 months of continuous AF);

5. Life expectancy > 12 months; and

6. Provides written informed consent.

Exclusion Criteria:

1. Patients requiring concomitant surgery such as valvular repair or replacement,coronary artery bypass graft (CABG) surgery and atrial septal defect closure;

2. Left ventricular ejection fraction < 35%;

3. Pregnant or planning to become pregnant during study;

4. Co-morbid medical conditions that limit one-year life expectancy;

5. Previous cardiac surgery;

6. History of pericarditis;

7. Previous cerebrovascular accident (CVA), excluding fully resolved TIA;

8. Patients who have active infection or sepsis

9. Patients with esophageal ulcers strictures and varices;

10. Patients with renal dysfunction who are not on dialysis (defined as GFR ≤ 40);

11. Patients who are contraindicated for anticoagulants such as heparin and coumadin;

12. Patients who are being treated for ventricular arrhythmias;

13. Patients who have had more than 2 prior left atrial catheter ablations for AF. NOTE:Note: Prior ablations should be limited to failed Pulmonary Vein Isolation (PVI) andno other left atrial lesions;

14. Current participation in another clinical investigation of a medical device or adrug, or recent participation in such a study within 30 days prior to studyenrollment;

15. Not competent to legally represent him or herself (e.g., requires a guardian orcaretaker as a legal representative);

16. Patient has presence of thrombus in the left atrium determined by intraoperativeTEE;

17. Patient exhibits pulmonary vein stenosis in one or more of the pulmonary veins >50 %stenosis;

18. Planned Left Atrial Appendage Management (LAAM) with an endocardial implantabledevice during the course of the study;

19. Presence of other anatomic or comorbid conditions, or other medical, social, orpsychological conditions that, in the investigator's opinion, could limit thesubject's ability to participate in the clinical investigation or to comply withfollow-up requirements, or impact the scientific soundness of the clinicalinvestigation results

20. Presence of Barretts esophagitis